Red Net At the time of Zhuzhou, December 19 (Reporter Hu Fang) The transition period of maternity insurance and basic medical insurance for employees is about to end at the end of this month. Do you know the relevant policies?The press conference of insurance mergers and implementation was held at the Municipal Government Press Center.At the meeting, Chen Zhihong, the party secretary and director of Zhuzhou Medical Security Bureau, introduced the development of maternity insurance and the combination of basic medical insurance for employees.
At the conference site.
Expand the beneficiary of maternity insurance for the people who make the insured less running
Beginning on November 1, 2019, Zhuzhou City has launched a comprehensive launch of maternity insurance and the implementation of the combination of basic medical insurance for employees.After the merger of maternity insurance and basic medical insurance for employees, the employees who participated in the basic medical insurance of employees participated in maternity insurance simultaneously. Before the merger of the two insurance mergers, the employees and their employees had registered for social insurance participation, but did not participate at the same time at the same time.In the basic medical insurance and maternity insurance, the medical insurance agency directly maintains and increases the corresponding insurance types.From November 1, 2019, the payment rate of the basic medical insurance unit of the employees of the normal insurance unit has increased from 8%to 8.7%, and the difficulty in paying employee medical insurance at a rate of 4%, the unit payment rate increases from 4%to 4%to4.7%, individuals do not pay maternity insurance premiums.After the implementation of the two insurance mergers, the management is unified by the management of the basic medical insurance.Ensure that maternity insurance for employees is unchanged.
Chen Zhihong said that through the implementation of the two insurance mergers and unified collection, the fund support capabilities were improved.At the same time, the beneficiary of maternity insurance beneficiaries, employees participating in basic medical insurance participated in maternity insurance simultaneously, and enjoy all the treatment of basic medical insurance and maternity insurance for employees. After the combination, it was equivalent to increasing more than 50,000 people to participate in maternity insurance.The medical expenses incurred by the insured persons will be paid from the basic medical insurance fund of the employee. From the statistical data, the two benefits of maternity medical expenses and fertility allowance will be reduced by an average economic burden of about 32,000 yuan for each insured person.
After the merger is implemented, the female employees who have fertilized in the urban area only need to hold the ID card (or social security card), the "Breeding Certificate", and "Pregnant Women’s Health Manual" directly after 20 weeks of pregnancy to before deliveryThe agreement medical institution shall go through the registration of maternity insurance benefits, and the prenatal inspection costs and fertility delivery medical expenses will be reimbursed directly in the selected agreement hospital.
Focus on people’s livelihood, reflect "Zhuzhou characteristics"
On the basis of implementing the implementation of superior documents, the Municipal Medical Insurance Bureau fully combines Zhuzhou’s actual situation, focusing on people’s livelihood concerns, and reflecting the "Zhuzhou characteristics".
Shorten the waiting time to enjoy maternity insurance benefits.The waiting period of the female employee or male employee spouse to enjoy maternity insurance expenses and one -time maternity subsidies will be reduced from the original insurance payment for 10 months to 1 month to ensure that the insured persons enjoy the timely maternity insurance benefits.
Retired personnel with less payment period are calculated at one time at the original 8ꖹpayment rate.For retirees who no longer enjoy maternity insurance, the payment rate of maternity insurance does not increase the rate of payment of maternity insurance, and reduces the economic burden of replenishment of retirees.
Set the policy transition period of two insurance mergers and implementation.Set from November to December 2019 as a transition period to solve the problem of settlement of maternity insurance history in arrears, and ensure that the insured persons enjoy medical insurance treatment normally.
[The question you care about]
1. After the combination of maternity insurance and basic medical insurance, maternity insurance treatment is not reduced. What are the specific fertility insurance benefits?
Cheng Miaoqing, director of the Zhuzhou Medical Security Center: Maternity insurance benefits include maternity medical expenses and maternity allowances.
The first is the cost of maternity medical care, which mainly includes: (1) family planning treatment, such as the cost of upper ring, ringing, abortion, induction of labor, ligation, etc. can be directly reduced according to the policy; (2) prenatal inspection costs, female employees, female employeesAfter being registered in the hospital after 20 weeks of pregnancy, the prenatal inspection fee can be reduced in a policy at a designated hospital; (3) fertility and childbirth costs. After the female employees are registered in the hospital, the fertility and childbirth costs) The cost of pregnancy complications. After 20 weeks of pregnancy, the female employee has 12 pregnancy complications such as hypertension and diabetes due to pregnancy.If the male employee spouse has no job and does not participate in the employee’s medical maternity insurance, the medical insurance fund has not paid the fertility medical expenses, the male employee can enjoy the one -time maternity subsidy;An unemployed female employee who pays medical insurance premiums can enjoy disposable maternity subsidies during the receipt of unemployment insurance premiums; (7) Flexible employees who are flexible employees, participating in employee medical insurance, and individuals do not need to pay maternity insurance costsHowever, the reimbursement of the expenses of prenatal inspections, childbirth, and pregnancy complications can still be enjoyed like an employee of the unit, but it is not allowed to enjoy fertility allowances.
The second is the maternity allowance. It refers to the continuous payment of medical fertility insurance for the insured. After 10 months of fertility, the following month can be given the next month. It can enjoy the maternity allowance (maternity leave salary) for 173 days.
2. What is the difference between urban employee medical insurance and urban and rural residents’ medical insurance?
Cheng Miaoqing, Director of the Medical Security Center of Zhuzhou City: The differences between medical insurance and urban and rural residents’ medical insurance for urban employees are mainly manifested in two aspects: the first is that the payment method is different. The employee medical insurance payment is paid by the employers and employees in accordance with regulations; urban and rural areas;Resident medical insurance payment is paid by individuals.The second is that the period of payment is different. When the employee medical insurance checks the retirement procedures of medical insurance, the cumulative payment period must meet the males for 30 years and the female for 25 years. The actual payment period in the province is not less than 10 years.You need to pay medical insurance premiums to directly enjoy medical insurance benefits; urban and rural residents’ medical insurance is one year, enjoying one year, and no policy without paying after retirement.The third is the treatment of enjoying the treatment. The medical insurance for employees enjoys the treatment of hospitalization reimbursement, special outpatient clinics and personal accounts. The proportion of inpatient reimbursement is more than 86%.More than 65%.
From October 1st to December 31st each year, the insurance payment period for urban and rural residents ‘medical insurance for urban and rural residents will be paid next year’s urban and rural residents’ medical insurance premiums shall promptly pay the fee within the prescribed time.