2026年，医保部门将推动将灵活就业人员、农民工、新就业形态人员纳入生育保险覆盖范围。合理提升产前检查医疗费用保障水平， 力争 全国基本实现政策范围内分娩个人"无自付"。将适宜的分娩镇痛项目按程序纳入基金支付范围。全面实现生育津贴按程序直接发放给参保 人。 据央视新闻，1 3日， 全国医疗保障工作会议在北京召开，国家医保局在会议上发布多项数据和措施。 其中包括，力争2026年全国基本实 现政策范围内分娩个人"无自付" 。 国家医保局表示，"十四五"期间，全国生育保险参保人数达2.55亿人。全国均已将符合条件的辅助生殖项目纳入医保支付，7个省份实现政 策范围内住院分娩医疗费用全额保障，近95%的统筹区将生育津贴直接发放给参保人。 ...

Key Points - The Chinese government aims to achieve "no out-of-pocket" expenses for childbirth within the policy framework by 2026, adapting to population development strategies and enhancing maternity insurance [1] - China's film box office is projected to exceed 50 billion yuan by 2025, with domestic films accounting for 81.90% of the total box office revenue [1] - The Ministry of Finance emphasizes the need to utilize various government bond funds effectively, issue ultra-long special bonds, and support "two new" initiatives to boost economic growth and consumer spending [2] - A new national standard for data security in electronic product information clearance will be implemented starting January 1, 2027, aimed at preventing data leakage in the second-hand electronics market [3]

Group 1 - The National Medical Insurance Administration aims to adapt to population development strategies by promoting maternity insurance and long-term care insurance by 2026 [1] - The initiative includes expanding maternity insurance coverage to flexible employment workers, migrant workers, and new employment forms, with a goal of achieving "no out-of-pocket" expenses for childbirth within the policy scope [1] - Seven provinces, including Jilin, Jiangsu, and Shandong, have already achieved a model where childbirth incurs no costs for insured individuals [1] Group 2 - The administration plans to optimize the medical insurance payment settlement mechanism by 2026, promoting healthy development in the medical sector [2] - A new version of the disease-based payment grouping scheme will be released, supporting the clinical use of new drugs and technologies [2] - The initiative includes enhancing the prepayment of medical insurance funds and exploring quarterly settlements to streamline the payment process [2]

Group 1 - The core viewpoint of the article emphasizes the development of maternity and long-term care insurance in China, aiming for comprehensive coverage and financial support for childbirth by 2026 [1] - The National Medical Insurance Administration plans to include flexible employment workers, migrant workers, and new employment forms in maternity insurance coverage, with a goal of achieving "no out-of-pocket" expenses for childbirth within the policy scope [1] - Recent improvements in hospitalization costs for childbirth have been noted, with provinces like Jilin, Jiangsu, and Shandong leading the way in making childbirth financially accessible [1] Group 2 - By 2026, the optimization of the medical insurance payment settlement mechanism is set to promote healthy development in the medical sector, including the release of a new version of the disease-based payment grouping plan [2] - The administration will implement quarterly or monthly special case reviews to support the clinical use of new drugs and technologies, as well as the treatment of complex severe cases [2] - There will be an emphasis on supporting grassroots medical institutions and promoting tiered diagnosis and treatment, alongside increasing prepayment of medical insurance funds and exploring quarterly settlements [2]

（文章来源：21世纪经济报道） 12月13日，全国医疗保障工作会议在京召开。会议做出最新部署，要积极适应人口发展战略，推动生育 保险和长期护理保险发展。推动将灵活就业人员、农民工、新就业形态人员纳入生育保险覆盖范围。合 理提升产前检查医疗费用保障水平，力争全国基本实现政策范围内分娩个人"无自付"。将适宜的分娩镇 痛项目按程序纳入基金支付范围。全面实现生育津贴按程序直接发放给参保人。全面推进长期护理保险 制度，优化长护服务供给。鼓励商保机构开发商业长期护理保险产品。近年来，我国全面提升住院分娩 医疗费用保障水平，积极推动政策范围内生育医疗费用全额保障。吉林、江苏、山东等7个省份已率先 实现生娃基本不花钱。 ...

Core Viewpoint - The article discusses the recent developments in China's maternity insurance policies, aiming for "no out-of-pocket" expenses for childbirth within the policy scope by next year [3][4]. Group 1: Policy Developments - The National Healthcare Security Administration (NHSA) is accelerating the establishment of a comprehensive maternity insurance system to support the population development strategy [4]. - By 2025, all 31 provinces and regions, including Xinjiang Production and Construction Corps, will include eligible assisted reproductive projects in the insurance coverage [4]. - Seven provinces have already achieved full coverage of hospitalization costs for childbirth within the policy scope, with 95% of coordinated areas directly providing maternity allowances to insured individuals [4]. Group 2: Key Initiatives - The NHSA's eight key tasks for next year include improving the maternity insurance system and expanding coverage to flexible workers, migrant workers, and new employment forms [4][5]. - There is an emphasis on exploring the feasibility of including non-employed urban and rural residents in the maternity insurance coverage [4]. - The NHSA aims to reasonably enhance the coverage level for prenatal examination medical expenses and explore the establishment of a basic service package that includes prenatal examination items to reduce the financial burden on insured individuals [5].

每经AI快讯，据国家医保局消息，12月13日，全国医疗保障工作会议在北京召开。会议要求，2026年 各级医保部门要深入推进医保改革，积极推进科技创新。积极适应人口发展战略，推动生育保险和长期 护理保险发展。推动将灵活就业人员、农民工、新就业形态人员纳入生育保险覆盖范围。合理提升产前 检查医疗费用保障水平，力争全国基本实现政策范围内分娩个人"无自付"。将适宜的分娩镇痛项目按程 序纳入基金支付范围。全面实现生育津贴按程序直接发放给参保人。全面推进长期护理保险制度，优化 长护服务供给。鼓励商保机构开发商业长期护理保险产品。 ...

Core Viewpoint - The article discusses the ongoing efforts to create a fertility-friendly society in China through various healthcare policies, particularly focusing on the direct payment of maternity benefits to female employees, which aims to alleviate financial burdens and enhance job security for women [3][4]. Summary by Sections Maternity Insurance and Benefits - Maternity insurance is one of the social insurance types in China, covering two main benefits: maternity medical expenses and maternity allowances, which are essentially paid during maternity leave [3]. - The average maternity allowance for female employees has exceeded 26,000 yuan, and it can be claimed without a marriage certificate [3][4]. Direct Payment Model - The National Healthcare Security Administration (NHSA) is promoting a direct payment model for maternity allowances, allowing funds to be deposited directly into the accounts of female employees, thus reducing the risk of delays or withholding by employers [4]. - As of November 1, 2023, 25 provinces, including Jiangsu and Liaoning, have implemented this direct payment model, covering nearly 90% of the regions [3][4]. Simplification of Claim Process - The NHSA has simplified the application process for maternity benefits, with most regions no longer requiring marriage certificates or other non-essential documents for claims [5]. - The primary documents needed now include an ID card or social security card and a medical diagnosis or discharge record [5]. Technological Advancements - Some regions have adopted "smart healthcare" systems, enabling a fully automated process for maternity allowance applications, allowing for real-time verification and direct payment without requiring physical visits [6]. Comprehensive Fertility Support System - The NHSA is working to establish a comprehensive fertility support system, enhancing medical expense coverage for childbirth and aiming for full reimbursement of maternity medical costs in several provinces [7]. - As of October 2023, all provinces have included assisted reproductive services in their insurance coverage, benefiting over 1 million individuals [7]. Future Directions - Despite progress in reducing economic burdens and enhancing medical service guarantees, challenges remain in addressing the concerns of young people regarding childbirth [7]. - Experts suggest that future fertility policies should engage with young adults to better understand their needs and work towards reducing the costs of raising children through coordinated multi-departmental efforts [7].

Core Points - The maternity allowance is calculated based on the average monthly salary of employees in the previous year at the employee's workplace, and it is exempt from personal income tax [3] - The formula for maternity allowance is: (average monthly salary of the employer in the month of termination of pregnancy ÷ 30 days) × number of days of maternity leave [3] - Generally, female employees tend to be younger and have shorter tenure, resulting in their workplace average salary being higher than their personal salary, leading to maternity allowances often exceeding their personal salaries [3] Maternity Leave Salary Payment - If a female employee has received maternity allowance and medical subsidies during maternity leave, and the allowance is higher than the average salary, the employer is not required to pay maternity leave salary; if it is lower, the company must make up the difference [6] - If the employer has not paid maternity insurance for the employee, the employee can request the company to pay maternity leave salary [6] Unmarried Childbirth and Coverage - Female employees are entitled to statutory maternity leave of 98 days and corresponding maternity allowance regardless of marital status, as long as there is a childbirth event; unmarried women who experience miscarriage can also enjoy 15 to 42 days of leave and apply for maternity leave salary [7] - The previous maternity insurance coverage was limited to enterprise employees, but it has now expanded to include flexible employment personnel, migrant workers, and new employment forms [9] - For example, in Shanghai, flexible employment personnel pay the basic medical insurance fee at the current rate, with 1% considered as maternity insurance contribution [9]

Core Points - The article discusses the implementation of direct payment of maternity benefits to individuals, with nearly 90% of medical insurance coordination areas achieving this goal [1][2] - The average maternity benefit for insured female employees is projected to exceed 26,000 yuan in 2024 [2] Group 1: Maternity Benefits Implementation - Over 20 provinces have successfully transitioned to direct payment of maternity benefits to individuals, simplifying the application process by eliminating the need for additional documents like birth permits and marriage certificates [2] - The process for claiming maternity benefits has been streamlined, with online one-stop services introduced in cities like Zhuzhou, reducing processing time from 20 working days to 10 [1] Group 2: Calculation and Payment of Maternity Benefits - Maternity benefits are calculated based on the average monthly salary of the employee's unit from the previous year, exempt from personal income tax [3] - If the maternity benefit exceeds the employee's average salary, the employer is not required to pay additional maternity wages; if it is lower, the employer must cover the difference [4] Group 3: Eligibility for Maternity Benefits - All women, regardless of marital status, are entitled to statutory maternity leave and corresponding benefits, including those who experience miscarriage [5] - The scope of maternity insurance has expanded to include flexible workers, migrant workers, and new employment forms, allowing them to participate in maternity insurance [6]