Pregnancy is a very hard thing, and every expectant mother not only has to adapt to and bear many changes in her body when she feels the happiness and joy of giving birth to a new life, but also faces the hardships of pregnancy and the test of childbirth. In the process of moving from expectant mother to mother, maternity insurance gives more care and protection to the insured from five dimensions.
Breadth: Wider coverage and more beneficiaries
Shouldering the mission of balancing unit labor costs, promoting equal employment between men and women, and ensuring the reproductive rights and interests of female employees, the maternity insurance system covers employers and their employees, protects the maternity rights and interests of insured employees, and the financing is paid by the employer, and the individual employees do not pay. In recent years, medical insurance departments at all levels have continued to promote the participation of maternity insurance employers, especially with the comprehensive promotion of the combined implementation of maternity insurance and employee medical insurance, employers and employees should participate in maternity insurance simultaneously when participating in employee medical insurance, and the coverage of maternity insurance has continued to expand, and the number of insured people has continued to rise, reaching 249 million in 2023, 1.5 times that of 2013. The number of people enjoying maternity insurance benefits increased from 5.22 million in 2013 to 17.68 million in 2022.
With the development of new forms of business and new economy, the CPC Central Committee and the State Council have paid close attention to the issue of medical care and maternity security for flexibly employed persons. In July 2022, 17 ministries and commissions jointly issued the "Guiding Opinions on Further Improving and Implementing Positive Childbirth Support Measures", which clearly stated that places with conditions can explore the inclusion of flexible employment personnel in the coverage of maternity insurance, and participate in maternity insurance at the same time as participating in employee medical insurance. Under the guidance of the National Health Insurance Administration, Jiangxi, Zhejiang, Tianjin, Guizhou and other provinces have carried out corresponding explorations, and the rights and interests of flexible employment personnel have been further protected.
Strength: The level of protection is higher, and the burden is greatly reduced
Through national legislation, maternity insurance guarantees that female employees will receive basic economic income and reimburse maternity-related medical expenses during the interruption of work due to pregnancy and childbirth. The protection of maternity medical expenses for insured female employees who give birth covers all aspects of prenatal examination, hospital delivery and family planning, so as to realize the full cycle of protection from pregnancy to childbirth. In 2022, the per capita maternity medical treatment expenditure of female employees insured by maternity insurance will be 5,899 yuan, 1.5 times that of 2013. As a substitute wage income for insured female employees to enjoy maternity leave, the maternity allowance helps insured female employees who give birth to enjoy "paid maternity leave" to protect their economic income and alleviate their worries. In 2022, the per capita maternity allowance for insured female employees will reach 24,000 yuan, twice that of 2013.
Ms. Liang, an insured employee in Zhuhai, Guangdong, was hospitalized in the local hospital for a smooth delivery, and the hospitalization cost a total of 3,492 yuan for maternity medical expenses. "Today's discharge settlement was reimbursed through maternity insurance, and in the end I only paid less than 100 yuan, and the maternity insurance also achieved direct settlement like medical insurance, so I don't have to go to the window to queue up, and I don't have to submit materials to apply later, which is very convenient. Ms. Liang said happily.
Thickness: Stronger mutual aid ability and more confident support
Compared with the resident medical insurance covering nearly 1 billion people and the employee medical insurance covering 370 million people, maternity insurance is relatively "small" in terms of the number of insured people, and the corresponding fund support capacity is relatively weak. How to give full play to the "big achievements" of "small insurance" and have more support capacity is a problem that the country has been thinking about. In 2019, the State Council issued the "Opinions on Comprehensively Promoting the Combined Implementation of Maternity Insurance and Basic Medical Insurance for Employees", which clearly merged the maternity insurance fund into the employee medical insurance fund, further enhancing the mutual aid capacity of the fund, further improving the management efficiency, and making the operation of the system more stable and sustainable. In 2023, the maternity insurance fund will spend 106.9 billion yuan, which is already 3.8 times that of 2013.
Width: Wider coverage items and wider payment scope
Maternity insurance implements the same catalogue of drugs, diagnosis and treatment items and medical service facilities as the basic medical insurance, and those that meet the scope of the catalogue can be included in the reimbursement. In order to meet the needs of the masses for diagnosis and treatment services, the state continues to adjust the scope of medical insurance payment. According to data, the infertility rate in China has increased from 12% in 2007 to 18% in 2020. The masses have called for something, and the policy has responded. In the process of adjusting the national medical insurance drug list, ovulation induction drugs such as bromocriptine, triptorelin, clomiphene and other eligible fertility support drugs have been included in the scope of medical insurance payment in a timely manner to safeguard women's reproductive rights. Also in 2022, the "Guiding Opinions on Further Improving and Implementing Positive Childbirth Support Measures" of 17 ministries and commissions further clearly stated that "local governments should be guided to comprehensively consider factors such as the affordability of medical insurance (including maternity insurance) funds, relevant technical norms, etc., and gradually include appropriate labor analgesia and assisted reproductive technology projects into the scope of fund payment according to procedures". At present, the policy is steadily being implemented, and more people will realize their dreams of childbirth in the future.
Temperature: It is more convenient to apply for treatment and enjoy services
"Let the data run more and let the masses run less errands" is the concept that the medical insurance service has always adhered to, and it is more intuitively reflected in the enjoyment of maternity insurance benefits. Continue to optimize the procedures for enjoying maternity insurance benefits, streamline the process, compress links, relax conditions, and clearly require that the enjoyment of maternity insurance benefits be linked to the insurance participation, and there is no longer a need to provide other non-essential additional materials such as "birth permit", "maternity service certificate" and "marriage certificate", so that the insured can live with peace of mind and comfort. Ms. Li's most profound experience in Henan Province is the cross-provincial policy of long-distance childbirth. In July 2023, she was hospitalized for childbirth in a hospital in Anyang, performed cesarean section, reimbursed 4,300 yuan for maternity hospitalization fees, 1,200 yuan for prenatal examination fees, and issued a maternity allowance of 35,077.04 yuan after the maternity leave. In the process, she also enjoyed various convenient measures for maternity insurance. Due to work reasons, she chose to give birth in a different place, originally thinking that she would face many difficulties and inconveniences, but the cross-provincial policy of maternity insurance saved her worry and effort. She only needs to upload the relevant information through the "Henan Medical Insurance" applet, and after the maternity medical expenses are approved, they will be directly allocated to the personal account she provides, and the maternity allowance will also be allocated to the unit account within 10 working days. The city-wide policy of applying for maternity treatment also made her feel the warmth and care of the policy.
Small insurance, big care. The "warm policy" of maternity insurance holds up the "stable happiness" of the insured.
Source: National Health Insurance Administration
Cover/Photo.com
Editor/Liao Yunqing
Review/Xiaoyue
Executive Producer/Qiao Hong