How to calculate the amount of maternity reimbursement for Chengdu elderly mothers?

Chengdu is an important economic center in southwest China, with many high-quality medical resources, providing good obstetric and gynecological services for the majority of elderly mothers. It is very important for Chengdu elderly mothers to know how to calculate the amount of maternity reimbursement. The following will be elaborated from four aspects.

Medical insurance policy and reimbursement ratio

The medical insurance policy of Chengdu provides clear provisions for the maternity reimbursement of elderly mothers. According to the provisions of relevant documents, the medical insurance coverage in Chengdu includes basic medical insurance for urban employees, basic medical insurance for residents and serious illness insurance. The amount of maternity reimbursement for elderly mothers is calculated mainly based on the total discharge expenses and the reimbursement proportion of medical insurance.

The specific reimbursement proportion is stipulated by the local medical insurance department. Generally, the reimbursement proportion of basic medical insurance for urban employees is 60% - 80%, the reimbursement proportion of basic medical insurance for residents is 50% - 70%, and the reimbursement proportion of serious disease insurance is more than 90%. Maternity expenses of elderly women belong to the category of basic medical expenses, which are calculated according to the reimbursement ratio of medical insurance policies.

For example, if the total discharge expenses of an elderly puerpera are 100000 yuan, and the reimbursement proportion is 80% according to the local medical insurance policy, then she can get the reimbursement amount of 80000 yuan.

Specific items of childbearing expenses

The childbirth expenses of the elderly puerpera involve many specific items, including hospitalization expenses, surgery expenses, drug expenses, examination expenses, etc. These expenses can be included in the reimbursement scope.

For example, hospitalization expenses include bed expenses, meal expenses, nursing expenses, etc; The operation expenses include the expenses for surgical instruments and drugs; Drug expenses include prenatal drug expenses, postoperative recovery drug expenses, etc; The examination fee includes prenatal examination fee, postoperative reexamination fee, etc. The detailed list of these expenses will be provided at the time of discharge settlement, and the corresponding reimbursement calculation will be carried out according to the medical insurance policy.

Compensation expenses under special circumstances

Under special circumstances, elderly mothers may face some additional costs, such as premature delivery, complications, etc. In these cases, the medical insurance will provide some compensation for the reimbursement of birth expenses.

Take premature delivery as an example. The premature infant needs additional care and treatment. In this case, the medical insurance will properly reimburse the cost of the premature infant. The treatment of complications is also a special case, and the medical insurance will reimburse the relevant expenses according to the specific circumstances.

Limit of actual reimbursement amount

The actual reimbursement amount of maternity expenses for elderly mothers is still subject to some restrictions. On the one hand, medical insurance has an upper limit for reimbursement of certain items, such as bed fees, surgery fees, etc. On the other hand, the part of individual payment also needs to be borne by oneself according to the medical insurance policy.

In addition, the expense difference between different hospitals will also cause the difference of reimbursement amount. The charging standards of different hospitals are different, and the elderly mothers need to consider the medical quality and cost factors comprehensively when choosing hospitals.

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The amount calculation of maternity reimbursement for Chengdu's elderly puerpera involves many aspects such as medical insurance policy, reimbursement proportion, maternity expense items and actual reimbursement amount limit. It is very important for the elderly mothers to understand these regulations, which can help them to reasonably plan the birth expenses and avoid omissions and losses in the reimbursement process.

Therefore, the elderly puerpera should know the provisions of the local medical insurance policy in advance, select the appropriate hospital for fertility services, and properly keep the relevant vouchers of medical expenses, so as to provide effective supporting materials when reimbursing.