本文目录一览:
- 1、生育保险报销条件
- 2、社保生育险报销条件
- 3、生育险报销条件是什么
生育保险报销条件
生育保险报销条件如下:
1、生育分娩时,用人单位已连续为生产者缴纳一年以上生育保险;
2、生育符合计划生育政策;
3、怀孕者未参与生育保险,其丈夫参与生育保险,且符合上述两个条件的,怀孕者可以使用其丈夫的生育保险进行报销。根据相关法律规定,用人单位已经缴纳生育保险费的,其职工享受生育保险待遇;职工未就业,配偶按照国家规定,享受生育医疗费用待遇。
拓展资料:
一、报销范围一般规定:
1、生育医疗费。女职工生育的检查费、接生费、手术费、住院费和药费由生育保险基金支付。超出规定的医疗业务费和药费(含自费药品和营养药品的药费)由职工个人负担。女职工生育出院后,因生育引起疾病的医疗费,由生育保险基金支付;其它疾病的医疗费,按照医疗保险待遇的规定办理。女职工产假期满后,因病需要休息治疗的,按照有关病假待遇和医疗保险待遇规定办理。
2、生育津贴。女职工依法享受产假期间的生育津贴,按本企业上年度职工月平均工资计发,由生育保险基金支付。
二、报销期限:
1、生育医疗费,应当在女职工妊娠至生育或者终止妊娠前申办;
2、生育津贴、一次性分娩营养补助费和异地就医的生育医疗费,应当在女职工生育或者终止妊娠后1年内申办;
3、计划生育手术费用,应当在手术前申办;
4、男职工假期津贴,应当在其配偶生育后1年内申办。逾期申办的,社会保险经办机构不予受理。用人单位未按规定期限到当地社会保险经办机构为其参保职工申办生育保险待遇的,该职工的生育保险待遇由用人单位按照所在统筹地区的待遇项目和标准支付。
社保生育险报销条件
社保生育险报销条件有:
1、用人单位为职工累计缴费满1年以上,并且继续为其缴费的;
2、符合国家和省人口与计划生育规定的。
符合以上条件的,女职工生育后,可以去社会保险经办机构办理报销登记,社会保险经办机构核实后,会为职工进行生育报销,会向职工支付相应的费用,费用的数额应当根据当地的规定进行确定。
《中华人民共和国社会保险法》
第五十四条 用人单位已经缴纳生育保险费的,其职工享受生育保险待遇;职工未就业配偶按照国家规定享受生育医疗费用待遇。所需资金从生育保险基金中支付。
生育保险待遇包括生育医疗费用和生育津贴。
第五十五条 生育医疗费用包括下列各项:
(一)生育的医疗费用;
(二)计划生育的医疗费用;
(三)法律、法规规定的其他项目费用。
生育险报销条件是什么
生育保险报销一般有3个条件:1、职工要符合国家计划生育政策,或实施计划生育手续,这是报销的基本条件。既可以是女职工,也可以是男职工的配偶;2、要按规定缴纳生育保险,单位给职工交纳的生育保险时间不低于一年,并且继续为其缴费的;3、由单位带相关证明到当地的社保机构办理。
【法律依据】
《中华人民共和国社会保险法》 第五十四条 用人单位已经缴纳生育保险费的,其职工享受生育保险待遇;职工未就业配偶按照国家规定享受生育医疗费用待遇。所需资金从生育保险基金中支付。生育保险待遇包括生育医疗费用和生育津贴。
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