What are the requirements for applying for maternity insurance benefits?
1, in line with the national population and family planning policy or family planning operation;
2. Female employees who have paid basic medical insurance and maternity insurance for three consecutive months in the same month (including the time limit for transfer and connection in different places, excluding the time limit for payment) shall enjoy the treatment of paying maternity medical expenses;
3. From the date of local insurance payment, female employees will pay full payment 12 months in the month of childbirth, and the medical insurance agency will pay the maternity allowance monthly. 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.
Maternity insurance has nothing to do with the year before pregnancy. However, if the general employer has paid the maternity insurance premium continuously for one year, and the female employee gives birth according to the family planning regulations, the maternity insurance benefits can be reimbursed. Maternity insurance benefits mainly include two items: one is maternity allowance, and the other is maternity medical care. Maternity insurance reimbursement conditions: 1. The employer has paid for employees for more than 1 year and continues to pay for employees. 2 in line with national and provincial population and family planning regulations.
I hope the above content can help you. If in doubt, please consult a professional lawyer.
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.
Article 55
Maternity medical expenses include the following contents:
(1) Maternity medical expenses;
(two) family planning medical expenses;
(3) Other project expenses stipulated by laws and regulations.
Article 56
Workers 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.
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 Workers
Female employees enjoy 98 days of maternity leave, including prenatal leave 15 days; 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.
"Trial Measures for Maternity Insurance for Enterprise Employees" Article 6
The examination fee, delivery fee, operation fee, hospitalization fee and medicine fee for the birth of female employees shall be paid by the maternity insurance fund. The medical service fee and medicine fee (including self-funded medicine and nutritional medicine) exceeding the prescribed amount shall be borne by the employees themselves.
After the female workers are discharged from the hospital, the medical expenses for diseases caused by childbirth shall be paid by the maternity insurance fund; The medical expenses of other diseases shall be handled in accordance with the provisions of medical insurance benefits. After the expiration of maternity leave, if a female employee needs rest and treatment due to illness, it shall be handled in accordance with the relevant provisions on sick leave and medical insurance benefits.