"This time, because of pregnancy-induced hypertension during childbirth, my medical expenses came to 8,764.43 yuan. When I checked out today, medical insurance directly reimbursed 6,744.72 yuan, and I paid 2,000 yuan myself, which greatly reduced the burden. Even the maternity allowance payment was handled 'without application,' and medical insurance services are becoming more and more convenient," said Ms. Luo, an insured employee in Hezhou City, Guangxi, excitedly.

The reporter recently learned from the National Healthcare Security Administration that, as of the end of 2023, the number of people covered by maternity insurance reached 249 million, an increase of 3.0041 million year on year. In 2023, maternity insurance fund benefit expenditures were 106.91 billion yuan, an increase of 11.775 billion yuan over the previous year, up 12.38%. The average maternity allowance for insured female employees reached 24,000 yuan.

It is reported that maternity insurance covers employers and their employees, ensuring that female employees receive basic economic income during the period when they interrupt work due to pregnancy and childbirth, and reimbursing maternity-related medical expenses. Funding comes from employer contributions, and employees do not pay individually.

Compared with resident medical insurance, which covers nearly 1 billion people, and employee medical insurance, which covers 370 million people, maternity insurance is relatively "small" in terms of the number of insured people, and its corresponding fund support capacity is relatively weak. How a "small insurance type" can play a "big role" is a question that relevant departments have been considering.

In 2019, the State Council issued the Opinions on Comprehensively Promoting the Combined Implementation of Maternity Insurance and Employee Basic Medical Insurance, clearly stating that the maternity insurance fund would be incorporated into the employee medical insurance fund, further enhancing the fund's mutual-aid capacity, further improving management efficiency, and making the system more stable and sustainable. The reporter learned that in 2023, maternity insurance fund benefit expenditures were 106.9 billion yuan, already 3.8 times that of 2013.

A relevant official of the National Healthcare Security Administration introduced that insured female employees can enjoy maternity leave after childbirth, and wages during this period are replaced by maternity allowances, which come from the maternity insurance fund under the "five social insurances and one housing fund." Examination fees, delivery fees, surgery fees, hospitalization fees, and medicine fees for female employees' childbirth are paid by the maternity insurance fund.

So how much is the maternity allowance? The Social Insurance Law clearly stipulates that it is calculated and paid according to the average monthly wage of employees in the employer unit where the employee works in the previous year. The official gave an example: if an insured female employee's monthly wage is 3,500 yuan, but the average monthly wage of employees in her unit in the previous year was 5,000 yuan, then this female employee's maternity allowance will be paid according to the unit's average monthly wage of 5,000 yuan.

"Overall, compared with the overall employed population in units, female employees giving birth are younger and have shorter tenure, and generally the average wage of their unit is higher than their own wage, so the maternity allowance received by female employees is often higher than their own wage." The official disclosed that the higher the unit's average wage, the higher the maternity allowance received by insured female employees giving birth.

At the same time, maternity insurance provides female employees with full-cycle protection from pregnancy to childbirth. At present, the number of routine prenatal checkups generally recommended by medical institutions is about 12. Most medical insurance coordinating regions, based on the routine items and standards of prenatal examinations, pay a fixed amount to expectant mothers or prenatal examination hospitals, with fixed standards ranging from nearly 1,000 yuan to more than 2,000 yuan.

According to statistics from health authorities, in 2021 the average medical cost per person for a natural birth in public hospitals was 3,547 yuan, and the average medical cost per person for a cesarean section was 9,119 yuan. At present, most coordinating regions implement fixed-amount payments for inpatient childbirth, with fixed standards set separately according to different delivery methods. According to statistics, in 2022, insured female employees nationwide received an average of 5,899 yuan in maternity medical expense reimbursement per person.

In addition, maternity insurance applies the same catalog of medicines, diagnostic and treatment items, and medical service facilities as basic medical insurance, and anything within the catalog scope can be included in reimbursement. Data show that in 2020, China's infertility rate reached 18%. In response to the situation of some families "wanting to have children but being unable to," during the adjustment process of the national medical insurance drug catalog, eligible fertility-support drugs such as bromocriptine, triptorelin, and clomiphene were promptly included in the scope of medical insurance payment.

With the development of new business forms and the new economy, in July 2022, 17 ministries and commissions jointly issued the Guiding Opinions on Further Improving and Implementing Active Fertility Support Measures, clearly proposing that qualified localities may explore including flexible employment personnel in the coverage of maternity insurance, so that they participate in maternity insurance at the same time as employee medical insurance. The reporter learned that Jiangxi, Zhejiang, Tianjin, Guizhou, and other provinces and municipalities have carried out corresponding explorations, further safeguarding the maternity rights and interests of flexible employment personnel.