1. Medical expenses for delivery. The hospitalization expenses, treatment expenses, examination expenses and medical expenses caused by diseases such as fertility that meet the basic medical insurance, industrial injury insurance, maternity insurance drug list, diagnosis and treatment items and service facilities list in our city during childbirth are included in the scope of maternity insurance payment. The prenatal examination fee shall be paid in a fixed amount, and the standard is 800 yuan, which shall be paid together with the delivery medical expenses.
2. Medical expenses for family planning operation. Including placing (taking out) IUD, subcutaneous implantation, skin removal and catgut embedding, abortion, induced labor, sterilization and recanalization, and medical expenses are paid according to the project quota.
The specific payment standard is: if the pregnancy is less than 4 months, the 400 yuan will be fixed; Pregnant for more than 4 months (including induced labor and stillbirth), the quota is 900 yuan; Placement (removal) of IUD, with a quota of 180 yuan; Subcutaneous implantation, peeling implantation, quota 120 yuan; Sterilization, quota 1200 yuan; For those who return to surgery, the quota is 1500 yuan.
Maternity allowance:
Maternity allowance is calculated and paid according to the following standards: the average monthly salary of female employees in the previous year divided by 30 days multiplied by the number of maternity leave days:
Women workers who give birth normally are entitled to 98 days of maternity allowance. Cesarean section 15 days for dystocia that meets the indications of cesarean section, and 15 days for multiple births.
Female employees who miscarry before four months of pregnancy are entitled to 15 days maternity allowance; Abortion after 4 months of pregnancy (including induced labor and stillbirth) is entitled to 42 days maternity allowance.
Maternity insurance benefits enjoy conditions:
(1) Maternity medical expenses. The waiting period of maternity medical expenses is the same as that of basic medical insurance. If the female employee has paid the basic medical insurance and maternity insurance for three consecutive months in the month of childbirth (including the time limit for transfer and continuation in different places, excluding the time limit for payment), the compliance medical expenses incurred will be settled according to the facts.
(2) Maternity allowance. Female employees who have paid full payment 12 months in the current month from the date of local insurance payment shall be paid monthly maternity allowance by the medical insurance agency. If the continuous payment in the month of childbirth is less than 12 months, it will be reissued monthly after the continuous payment by the unit 12 months.
Legal basis: Article 25 of the Population and Family Planning Law of the People's Republic of China. Couples who have children in accordance with laws and regulations can get extended maternity leave or other welfare benefits.
Article 7 of the "Special Provisions on Labor Protection of Female Employees" allows female employees to enjoy 98 days of maternity leave, including 15 days before delivery; In case of dystocia, maternity leave shall be increased 15 days; For multiple births, the maternity leave can be increased by 1 5 days for each additional child. Female employees who miscarry less than 4 months after pregnancy are entitled to 15 days maternity leave; Abortion after 4 months of pregnancy is entitled to 42 days of maternity leave.
People's Republic of China (PRC) social insurance law
Fifty-third employees should participate in maternity insurance, the employer should pay maternity insurance premiums in accordance with state regulations, and employees do not pay maternity insurance premiums.
Fifty-fourth employers have paid maternity insurance premiums, and their 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.
Fifty-fifth maternity medical expenses include the following:
(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.