(two) delivery and abortion (cited) medical expenses quota standard:
1, natural delivery: level III hospital 1500 yuan, level II hospital 1200 yuan, level I hospital 980 yuan;
2. Midwifery: 2,000 yuan for tertiary hospitals, 2 hospitals 1600 yuan, and 1 hospitals 1350 yuan;
3. Cesarean section: 3,000 yuan for tertiary hospitals, 2,400 yuan for secondary hospitals, and 1.980 yuan for primary hospitals;
4. Mid-term induced labor that meets the requirements of family planning and needs to terminate pregnancy due to maternal and infant reasons: tertiary hospital10.5 million yuan, secondary hospital10.2 million yuan, and primary hospital10.0 million yuan;
5. Inpatient induced abortion: tertiary hospital 580 yuan, secondary hospital 480 yuan, primary hospital 390 yuan;
6. Outpatient induced abortion: tertiary hospitals 180 yuan, secondary hospitals 150 yuan, and primary hospitals 130 yuan.
In line with the maternity insurance conditions, the cost of maternity and abortion (cited) is less than 90% (inclusive) of the quota standard, and the social insurance agency shall settle with the designated medical institution according to the actual cost; When the medical expenses are higher than 90% of the quota standard and lower than 100% (inclusive), they shall be settled according to the quota; For the part where the medical expenses are higher than the fixed standard 100% and lower than 150% (inclusive), individuals shall bear 30%, medical institutions shall bear 30%, and maternity insurance fund shall pay 40%; If the medical expenses are higher than the quota standard 150%, the individual shall bear 30%. The remaining part is determined by the social insurance agency according to the annual assessment results of medical services of designated medical institutions.
(three) the single limit of postpartum visit fee, the standard is 15 yuan/person, and the cumulative limit is 30 yuan.
In addition, maternity allowance is the employee's payment base divided by 30, and then multiplied by the maternity leave time (ordinary maternity leave+difficult maternity leave+late maternity leave).
Reimbursement during maternity leave refers to maternity allowance, no bonus and no violation.
The maternity insurance fund has been reimbursed enough, and most of the expenses for giving birth are at their own expense.
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