1. Reimbursement of maternity medical expenses: The insured person of maternity insurance can reimburse maternity medical expenses when giving birth in the obstetric department of the hospital, including delivery expenses, prenatal examination expenses, postpartum examination expenses, caesarean section operation expenses, neonatal observation expenses, etc. The proportion of reimbursement is generally 70% to 90%, and the specific proportion and reimbursement amount vary according to regional policies and hospital charging standards;
2. Payment of maternity allowance: the insured person of maternity insurance can receive maternity allowance after giving birth. The general standard is a certain proportion of maternity medical expenses, and the specific proportion and standard are different according to regional policies. Maternity insurance participants can also receive benefits such as one-time maternity allowance and reproductive health handbook.
The reimbursement process of maternity insurance in social security is as follows:
1, go through the reimbursement procedures for maternity insurance: when giving birth in the hospital, the insured person of maternity insurance should provide his/her ID card, insurance certificate and other materials to go through the reimbursement procedures for maternity insurance. Specific procedures and material requirements may vary from region to region and hospitals, and the opinions of local hospitals and social security institutions need to be consulted;
2. Payment of medical expenses: Maternity insurance participants need to pay corresponding medical expenses when giving birth in the hospital, including delivery expenses, prenatal examination expenses, postpartum examination expenses, caesarean section operation expenses, neonatal observation expenses, etc. Under normal circumstances, the insured person of maternity insurance can choose to pay the medical expenses first, and then go through the reimbursement procedures, or go through the reimbursement procedures directly in the hospital, and the hospital will pay the medical expenses on his behalf;
3. Submit an application for reimbursement: the insured person of maternity insurance needs to submit an application for reimbursement of maternity insurance within the specified time, generally within 30 days after the settlement of maternity medical expenses. The application for reimbursement needs to include related medical expense invoices, expense detailed lists, medical certificates and other materials, and generally needs to fill in the maternity insurance reimbursement application form;
4. Review and reimbursement: Social security agencies review the application for reimbursement of maternity insurance, and check the authenticity and legality of medical expenses and materials. After the approval, the social security agency will arrange the corresponding reimbursement procedures and amount, and transfer the reimbursement amount to the insured's bank account.
To sum up, there may be differences in the reimbursement procedures and policies of maternity insurance in different regions. It is recommended to know the local maternity insurance policies and reimbursement procedures before joining the insurance, so as to enjoy maternity insurance related benefits in time when necessary.
Legal basis:
Article 53 of the Social Insurance Law of People's Republic of China (PRC)
Employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with state regulations, and employees shall not pay maternity insurance premiums.
Article 54
The employer has paid maternity insurance, and its employees enjoy maternity insurance benefits; Unemployed spouses of employees enjoy maternity medical expenses in accordance with state regulations. The required funds are paid from the maternity insurance fund. Maternity insurance benefits include maternity medical expenses and maternity allowance.