According to the provisions of Article 12 of the Maternity Insurance Measures, maternity medical expenses include maternity medical expenses, family planning medical expenses and other project expenses that should be paid by the maternity insurance fund according to laws and regulations. Family planning medical expenses refer to the medical expenses incurred by workers in placing or taking out intrauterine devices, performing tubal or vas deferens ligation and recanalization operations, and performing induced abortion or induced labor.
Thirteenth maternity insurance personnel in the medical service institutions agreed medical expenses, in line with the maternity insurance drug list, diagnosis and treatment items and medical service facilities standards, paid by the maternity insurance fund. If you need emergency treatment or rescue, you can seek medical treatment in a non-agreed medical service institution.
Extended data:
Article 55 of People's Republic of China (PRC) Social Insurance Law includes the following contents:
(1) Maternity medical expenses;
(two) family planning medical expenses;
(3) Other project expenses stipulated by laws and regulations.
Fifty-sixth employees in any of the following circumstances, can enjoy maternity allowance in accordance with state regulations:
(1) Female employees enjoy maternity leave;
(2) Enjoy family planning operation leave;
(3) Other circumstances stipulated by laws and regulations.
Maternity allowance is calculated and paid according to the average monthly salary of employees in the previous year of the employer.
Maternity insurance benefits shall be applied by the employing unit to the social insurance agency within 18 months after the delivery or operation of the employee. When applying, the employer shall fill in the application form for maternity insurance benefits of the employee and provide the following information:
Birth certificate issued by the family planning administrative department; Original materials such as reproductive medical certificate, outpatient medical records, discharge summary, and family planning operation records; A baby's birth certificate. The social insurance agency shall, within 15 working days from the date of accepting the application, review the information provided by the employer, and after the completion of the review, allocate the maternity insurance premium to the employer where the employee is located, and the employer shall distribute it to the employee according to the maternity insurance treatment items and standards stipulated in the present Measures. If the employer fails to handle the maternity insurance procedures for the employees as required, the maternity insurance expenses incurred by the employees shall be paid by the employer in accordance with the maternity insurance treatment items and standards stipulated in these Measures. The materials required for reimbursement are: medical expense declaration form; My ID card or social medical security card; I have a bank card with UnionPay logo; My medical record book; Original production cost; A detailed list of expenses; Summary of discharge. You'd better take your birth certificate. If someone else picks it up, you need to bring the ID card of the person who picks it up.