南京医保出台措施积极支持三孩政策落地！（附待遇标准）
<section data-role="outer" label="Powered by 135editor.com" style=""><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">南京市生育保险和基本医疗保险自去年合并实施以来，生育保险基金运行平稳，2021年上半年参保人数达327.47万人，待遇享受人数9.9万人，其中生育人数2.4万人；生育基金支出8.6亿元。近期，根据国家、省《关于做好三孩政策生育保险工作的通知》要求，<span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;"><strong>南京医保出台措施积极支持三孩政策落地。</strong></span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 18px; color: #BE7763;"><strong><span style="font-size: 18px; font-family: PingFangSC-Regular;">参加生育保险的职工生育三孩的</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">，凭街道办事处（镇政府）或社区居委会（村委会）出具的三孩生育登记证明按规定享受生育保险各项待遇。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 18px; color: #BE7763;"><strong><span style="font-size: 18px; font-family: PingFangSC-Regular;">未参加生育保险</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">，参加我市职工基本医疗保险的灵活就业人员和居民基本医疗保险参保人员生育三孩发生的生育的医疗费用，凭街道办事处（镇政府）或社区居委会（村委会）出具的三孩生育登记证明按规定享受待遇。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><section class="_135editor" data-tools="135编辑器" data-id="105224"><section style="text-align: center;margin: 10px auto;"><section style="display: inline-block;"><section style="display: flex;justify-content: center;align-items: center;"><section style="background-color: #fff;padding: 5px;border-radius: 50%;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-ms-transform: rotate(0deg);-o-transform: rotate(0deg);"><section style="box-sizing:border-box;background-color: #fe4e3d;width: 30px;height: 30px;border-radius: 50%;"><section style="font-size: 14px;letter-spacing: 1.5px;color: #fff;line-height: 30px;margin-left: 2px;"><span style="font-family: PingFangSC-Regular;">01</span></section></section></section><section style="background-color: rgb(255, 233, 232); padding: 5px 15px 5px 30px; margin-left: -15px; box-sizing: border-box;"><section class="135brush" data-brushtype="text" style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;" hm_fix="317:493"><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;"><strong><span style="font-size: 18px; font-family: PingFangSC-Regular;">生育保险享受条件？</span></strong></span></section></section></section></section></section></section><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">①符合国家、省、市计划生育政策规定；</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">②职工所在用人单位按时足额缴纳生育保险费的，职工按照规定享受生育保险待遇；职工的生育津贴和一次性营养补助，在用人单位连续缴费满10个月后，由生育保险基金支付。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p><br></p><section class="_135editor" data-tools="135编辑器" data-id="105224"><section style="text-align: center;margin: 10px auto;"><section style="display: inline-block;"><section style="display: flex;justify-content: center;align-items: center;"><section style="background-color: #fff;padding: 5px;border-radius: 50%;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-ms-transform: rotate(0deg);-o-transform: rotate(0deg);"><section style="box-sizing:border-box;background-color: #fe4e3d;width: 30px;height: 30px;border-radius: 50%;"><section style="font-size: 14px;letter-spacing: 1.5px;color: #fff;line-height: 30px;margin-left: 2px;"><span style="font-family: PingFangSC-Regular;">02</span></section></section></section><section style="background-color: rgb(255, 233, 232); padding: 5px 15px 5px 30px; margin-left: -15px; box-sizing: border-box;"><section class="135brush" data-brushtype="text" style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;" hm_fix="332:491"><strong><span style="font-size: 18px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">生育保险有哪些待遇？</span></strong></section></section></section></section></section></section><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: rgb(166, 91, 203); font-size: 18px; font-family: PingFangSC-Regular;"><strong>生育保险待遇包括：</strong></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">①门诊产前检查费用；</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">②分娩医疗费用；</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">③计划生育手术费用；</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">④生育津贴；</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">⑤一次性营养补助费。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: #BE7763; font-size: 18px;"><strong><span style="color: rgb(190, 119, 99); font-family: PingFangSC-Regular;">门诊产前检查费用：</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">是指从建《孕产妇保健卡（册）》开始至住院分娩前所需相关检查费、化验费。门诊产前检查费用，由生育保险基金支付。参保职工在本人所选生育保险定点医疗机构进行门诊产前检查发生的符合生育保险支付范围和标准的费用，属生育保险基金支付的，由市医保经办机构与定点医疗机构结算；属个人支付的，由本人与定点医疗机构结算。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: #BE7763; font-size: 18px;"><strong><span style="color: rgb(190, 119, 99); font-family: PingFangSC-Regular;">分娩医疗费用：</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">指因顺产（包括手法助产）、助娩产（包括产钳助产、胎头吸引、臀位助产、臀位牵引）、剖宫产三种分娩方式所需的检查费、接生费、手术费、普通病房住院费、医药费等医疗费用。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">参保职工在生育保险定点医疗机构发生的符合生育保险支付范围和标准的费用，在使用乙类药品和医疗服务时，应先按规定比例自付，再按以下规定享受待遇。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(190, 119, 99); font-family: PingFangSC-Regular;"> <span style="color: rgb(190, 119, 99); font-size: 15px; font-family: PingFangSC-Regular;"> 顺产2000元、助娩产2200元、剖宫产3500元以下的费用，由基金支付；</span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: rgb(84, 141, 212); font-size: 15px; font-family: PingFangSC-Regular;"> 顺产2001～4000元、助娩产2201～4500元、剖宫产3501～6000元之间的费用，在三级医疗机构就医的，个人负担5%，在二级及以下医疗机构就医的，个人不负担；</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: rgb(166, 91, 203); font-size: 15px; font-family: PingFangSC-Regular;"> 顺产4001元、助娩产4501元、剖宫产6001元以上的医疗费用，在三级医疗机构就医的，个人负担25%，在二级及以下医疗机构就医的，个人不负担。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 18px;"><strong><span style="color: rgb(190, 119, 99); font-family: PingFangSC-Regular;">计划生育手术的范围：</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">放置（取出）宫内节育器、早期妊娠流产、中期妊娠流（引）产、输卵（精）管绝育及复通手术。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">参保职工在生育保险定点医疗机构实施计划生育手术发生的符合生育保险支付范围和标准的医疗费用，在使用乙类药品和医疗服务时，应先按规定比例自付，再按规定享受待遇。</span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: #BE7763; font-size: 18px;"><strong><span style="color: rgb(190, 119, 99); font-family: PingFangSC-Regular;">生育津贴：</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">是职工按照国家和省有关规定享受产假或者计划生育手术休假期间获得的工资性补偿。<span style="font-size: 16px; color: rgb(30, 155, 232); font-family: PingFangSC-Regular;"><strong>生育津贴按照职工产假或者休假天数计发，计发基数为职工所在用人单位上年度职工月平均工资除以30。</strong></span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">生育的</span></span></strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">，享受128天生育津贴，</span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">其中难产的</span></span></strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">，增加15天的生育津贴；</span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">生育多胞胎的</span></span></strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">，每多生育1个婴儿，增加15天的生育津贴。</span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">计划生育的</span></span></strong><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;"><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">享受2-42天生育津贴。</span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: #BE7763; font-size: 18px;"><strong><span style="color: rgb(190, 119, 99); font-family: PingFangSC-Regular;">一次性营养费：</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">职工生育或者妊娠满7个月引产的，发给一次性营养补助，<span style="font-size: 16px; color: rgb(30, 155, 232); font-family: PingFangSC-Regular;"><strong>标准为全省城镇非私营单位在岗职工年平均工资的2%</strong></span>，<span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;"><strong>2021年7月1日起一次性营养补助为2760元。</strong></span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p><br></p><section class="_135editor" data-tools="135编辑器" data-id="105224"><section style="text-align: center;margin: 10px auto;"><section style="display: inline-block;"><section style="display: flex;justify-content: center;align-items: center;"><section style="background-color: #fff;padding: 5px;border-radius: 50%;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-ms-transform: rotate(0deg);-o-transform: rotate(0deg);"><section style="box-sizing:border-box;background-color: #fe4e3d;width: 30px;height: 30px;border-radius: 50%;"><section style="font-size: 14px;letter-spacing: 1.5px;color: #fff;line-height: 30px;margin-left: 2px;"><span style="font-family: PingFangSC-Regular;">03</span></section></section></section><section style="background-color: rgb(255, 233, 232); padding: 5px 15px 5px 30px; margin-left: -15px; box-sizing: border-box;"><p style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;"><span style="font-size: 18px;"><strong><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">男职工可以享受</span></strong></span></p><p style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;"><span style="font-size: 18px;"><strong><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">哪些生育待遇？</span></strong></span></p></section></section></section></section></section><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">①<span style="font-size: 16px; color: rgb(190, 119, 99); font-family: PingFangSC-Regular;"><strong>男职工</strong></span>符合国家和省有关规定<span style="font-size: 16px; color: rgb(190, 119, 99); font-family: PingFangSC-Regular;"><strong>享受护理假的，享受15天生育津贴；</strong></span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">②<span style="font-size: 16px; color: rgb(190, 119, 99); font-family: PingFangSC-Regular;"><strong>男职工实施计划生育手术的医疗费用，由基金支付。</strong></span></span></p><p><br></p><p><br></p><section class="_135editor" data-tools="135编辑器" data-id="105224"><section style="text-align: center;margin: 10px auto;"><section style="display: inline-block;"><section style="display: flex;justify-content: center;align-items: center;"><section style="background-color: #fff;padding: 5px;border-radius: 50%;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-ms-transform: rotate(0deg);-o-transform: rotate(0deg);"><section style="box-sizing:border-box;background-color: #fe4e3d;width: 30px;height: 30px;border-radius: 50%;"><section style="font-size: 14px;letter-spacing: 1.5px;color: #fff;line-height: 30px;margin-left: 2px;"><span style="font-family: PingFangSC-Regular;">04</span></section></section></section><section style="background-color: rgb(255, 233, 232); padding: 5px 15px 5px 30px; margin-left: -15px; box-sizing: border-box;" hm_fix="326:479"><p style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;"><span style="font-size: 18px;"><strong><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">灵活就业人员生育待遇</span></strong></span></p><p style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;"><span style="font-size: 18px;"><strong><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">和职工医保有哪些不同？</span></strong></span></p></section></section></section></section></section><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: #BE7763;"><strong><span style="font-size: 16px; font-family: PingFangSC-Regular;">灵活就业人员不缴纳生育保险</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">，按照生育保险的待遇标准，享受生育的医疗费用待遇，<span style="font-size: 16px; color: rgb(30, 155, 232); font-family: PingFangSC-Regular;"><strong>即产前检查费用及分娩医疗费用，由基本医疗保险统筹基金支付。</strong></span></span></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p><br></p><section class="_135editor" data-tools="135编辑器" data-id="105224"><section style="text-align: center;margin: 10px auto;"><section style="display: inline-block;"><section style="display: flex;justify-content: center;align-items: center;"><section style="background-color: #fff;padding: 5px;border-radius: 50%;transform: rotate(0deg);-webkit-transform: rotate(0deg);-moz-transform: rotate(0deg);-ms-transform: rotate(0deg);-o-transform: rotate(0deg);"><section style="box-sizing:border-box;background-color: #fe4e3d;width: 30px;height: 30px;border-radius: 50%;"><section style="font-size: 14px;letter-spacing: 1.5px;color: #fff;line-height: 30px;margin-left: 2px;"><span style="font-family: PingFangSC-Regular;">05</span></section></section></section><section style="background-color: rgb(255, 233, 232); padding: 5px 15px 5px 30px; margin-left: -15px; box-sizing: border-box;"><p style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;"><span style="font-size: 18px;"><strong><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">城乡居民医保可以</span></strong></span></p><p style="font-size: 16px;letter-spacing: 1.5px;color: #ff403e;"><span style="font-size: 18px;"><strong><span style="color: rgb(235, 103, 148); font-family: PingFangSC-Regular;">享受哪些生育待遇？</span></strong></span></p></section></section></section></section></section><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><br></p><p style="text-align:justify;line-height: 1.75em; margin-left: 10px; margin-right: 10px;" align="justify"><span style="color: #BE7763;"><strong><span style="font-size: 16px; font-family: PingFangSC-Regular;">城乡居民医保参保人员</span></strong><strong><span style="font-size: 16px; font-family: PingFangSC-Regular;">享受生育的医疗费用待遇</span></strong></span><span style="font-size: 16px; color: rgb(63, 63, 63); font-family: PingFangSC-Regular;">，一个待遇年度内发生的<span style="font-size: 16px; color: rgb(30, 155, 232); font-family: PingFangSC-Regular;"><strong>产前检查费用，基金支付比例40%，基金支付限额300元；</strong></span><span style="font-size: 16px; color: rgb(235, 103, 148); font-family: PingFangSC-Regular;"><strong>发生的生育住院分娩费用，参照住院支付政策执行，其中在三级医疗机构就诊的，基金支付75%。</strong></span></span></p><p><br></p><section class="_135editor" data-role="paragraph"><p><br></p></section></section>
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