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Medicare guidelines

time: 2017-08-10

Health guide
1.Reimbursement conditions:

(1)To meet the family planning policy;

(2)The on-the-job female worker who has been in the job for 12 months before birth (the second child must also conform to the condition of pregnancy after the second birth certificate).

2.Materials for reimbursement:

(1)The female staff unit shall provide a letter of recommendation from the unit;

(2)Photocopy of female employee's identity card;

(3)Birth certificate issued by the department of family planning (family planning service manual) original and photocopy, registered permanent residence in the province, to birth a child, need to provide a unified national standard of the original and the copy of the examination certificate of the floating population;

(4)Original and photocopy of birth certificate; (original copy of infant death certificate);

(5)Original copy of medical expenses receipt (including the original receipt of medical expenses for prenatal examination);

(6)A copy of the first page of the patient's medical record and a copy of the doctor's order (a copy of the hospital seal must be stamped on the front page of the patient's medical record);

(7)Patients with reproductive complications should be provided with a detailed list of admission, discharge certificate and hospitalization expenses;

(8)Provide the female employee to build the bank passbook or build the bank account, the bankbook or the card and the card copy to a piece of A4 paper and mark the contact number.

3.Maternity insurance is divided into three parts: part of maternity leave, part maternity allowance and part medical service.

(1)Maternity leave:

with 4 months pregnant aborted fetuses of maternity leave 15 to 30 days, 15 days less than two months of abortion, 2 months less than 3 months for 20 days, three months less than four months of aborted fetuses for 30 days, more than 4 months maternity leave of aborted fetuses 42 days;

The normal maternity leave is 90 days, the increase of the difficult labor is 15 days, the multiple birth of multiple births, the increase of 15 days per additional baby, the rise of the late childbirth 60 days.
 

(2)Part of the maternity allowance:

During maternity leave, the employer will not pay the wages, and the maternity insurance fund shall pay the maternity allowance. The calculation formula is: the average monthly payment of salary paid by female employees in the company's unit is 30 days

(3)Treatment standard of maternity medical treatment:

Unit of choose and employ persons on time the birth insurance premium of pay of full specified amount, it meet the requirements of the family planning policy treatment for female worker is borne or aborted fetuses, including prenatal examination, delivered, operation expenses, hospitalization expenses, expenses for medicine, implements the fixed lump sum, pay by birth insurance fund according to the following standards.

300 yuan of miscarriage;

 1600 yuan ($485) for abortion or pregnancy;

1, 600 yuan of production;

3800 yuan for cesarean section.

4.Application for maternity insurance benefits:

(1)Declaration time: 1-10 per month;

(2)Female worker is born or lead, flow and carry out family planning operation hind, the worker of unit of choose and employ persons is carried by the person of unit of choose and employ persons to go to city health insurance to deal with birth insurance business. What needs to be explained is, the city health insurance office every Thursday afternoon maintains the system, does not deal with the maternity insurance business.

Among them: the pregnancy dissatisfaction 4 months abortion is 300 yuan, remain unchanged; The number of births or pregnancies that are over 4 months or more is increased from 1,600 yuan to 2,200 yuan. The vaginal operation was raised from 2,000 yuan to 2,700 yuan. The number of caesarean sections increased from 3,800 yuan to 4,600 yuan.

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