当前，我国人口发展进入关键转折期，总和生育率持续低于更替水平，婚育年龄普遍推迟且不孕不育比 例提升，新就业形态成为吸纳劳动力的主要方式，这些变化都对生育保险制度提出了新的要求。 当前，我国生育保险制度覆盖范围主要为企业职工，由用人单位缴费，职工个人不缴费。用人单位雇用 和招录职工，无论男女，都应为其参加生育保险。 生育保险保障的待遇包括两类：一是生育医疗费用待遇，参保女职工可按规定报销生育相关的医疗费 用，包括产前检查、住院分娩和计划生育的医疗费用，具体来说就是女职工生育的检查费、接生费、手 术费、住院费和药费等，由生育保险按规定支付；二是生育津贴，是指在分娩后休产假期间获得基本经 济收入，2024年全国参保女职工人均生育津贴超2.6万元。 中国人口学会的相关调查显示，在生育众多的配套支持政策中，经济类措施是最受欢迎和最有效的措 施，而生育保险是其中之一。医疗费用和生育津贴是缓解生育成本高，保障产后收入的重要举措。 推动生育保险和长期护理保险发展。 生育保险制度正迎来新一轮扩围与升级。 全国医保工作会议最新要求，2026年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。这意味着，灵活就业人员 ...

12月13日，全国医疗保障工作会议在北京召开。国家医保局党组书记、局长章轲在会上表示，2026 年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。"要做到让孕产妇从大肚子进医院到 抱娃出医院，住院分娩过程中产生的、属于医保目录范围内的费用，参保人个人基本不花钱。" 可见，一系列综合性、规划性措施表明，提高生育养育成本公共化水平，不是某个环节或某个部门 的任务，而是涉及诸多民生保障的工作。生娃基本"不花钱"，看起来相比"养娃"省得不算多，但却具有 普惠性和兜底性的特点，是完善生育保障体系不可或缺的基础。接下来，更需要保证政策的全面落地， 进一步形成"生得起、养得好、教得优"的保障闭环，为生育友好型社会不断注入制度的担当与关怀。 据新华社报道，目前，广东、山东、江苏等7个省份已实现政策范围内住院分娩医疗费用全额保 障。以山东济南为例，就有受访者表示，10年前自己的第一个孩子从产检到出生，一共花了3万元左 右，其中住院及分娩的费用占了一大半；而2025年起，由于济南产妇住院分娩的费用已经实现了医保目 录内全报销，受访者向媒体提供的一张"生娃账单"显示，个人账户仅需支付438.74元。不仅如此，适宜 的分娩镇 ...

Group 1 - The National Healthcare Security Administration (NHSA) held a national healthcare security work conference on December 13, outlining eight key work requirements aimed at enhancing healthcare for the population and supporting economic and technological development by 2026 [1] - NHSA aims to achieve "no out-of-pocket" expenses for childbirth within the policy scope nationwide by next year, including coverage for suitable childbirth pain relief projects and direct disbursement of maternity allowances to insured individuals [1] - A comprehensive long-term care insurance system is being promoted, with encouragement for commercial insurance institutions to develop long-term care insurance products [1] Group 2 - All 31 provinces (regions, municipalities) and the Xinjiang Production and Construction Corps have included eligible assisted reproductive projects in the healthcare insurance, with seven provinces achieving full coverage of hospitalization costs for childbirth within the policy scope [1] - 95% of the pooling areas directly disburse maternity allowances to insured individuals, reflecting the establishment of a full-cycle maternity security system [1] - Provinces such as Jilin, Jiangsu, and Shandong have successfully implemented a system where childbirth incurs minimal costs for families [1]

2025年，31个省（区、市）及新疆生产建设兵团均已将符合条件的辅助生殖项目纳入医保，7个省 份实现政策范围内住院分娩医疗费用全额保障，95%的统筹区将生育津贴直接发放给参保人。 2025.12. 13 本文字数：631，阅读时长大约1分钟 作者 | 第一财经 郭晋晖 12月13日，全国医疗保障工作会议在北京召开。国家医保局做出最新部署，力争明年全国基本实现 政策范围内分娩个人"无自付"。 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。 近年来，国家医保局加快建立全周期的生育保障体系，助力"怀得上、孕得优、生得安、育得好"。 （注：我们会对线索进行核实。您的隐私将严格保密。） 推荐阅读 史上最大的IPO要来了？ "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"是明年国家医保局的八项重点工作之 一。 国家医保局要求，完善生育保险制度。大力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，并积极探索将城乡非就业人员纳入覆盖范围的可行性。根据医保基金可承受能力，合 理提升产前检查医疗费用保障水平，探 ...

力争明年全国基本实现政策范围内分娩个人"无自付"。 12月13日，全国医疗保障工作会议在北京召开。国家医保局做出最新部署，力争明年全国基本实现政策 范围内分娩个人"无自付"。 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。 近年来，国家医保局加快建立全周期的生育保障体系，助力"怀得上、孕得优、生得安、育得好"。 "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"是明年国家医保局的八项重点工作之一。 国家医保局要求，完善生育保险制度。大力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，并积极探索将城乡非就业人员纳入覆盖范围的可行性。根据医保基金可承受能力，合理提 升产前检查医疗费用保障水平，探索制定包括产前检查项目在内的基本服务包，减轻参保人生育医疗费 用负担，力争全国基本实现政策范围内分娩个人"无自付"。所有省份均要将适宜的分娩镇痛项目按程序 纳入基金支付范围，落实完善辅助生殖技术项目医保支付管理。 2025年，31个省（区、市）及新疆生产建设兵团均已将符合条件的辅助生殖项目纳入医保，7个省份 ...

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 Insights - The article discusses the implementation of direct payment of maternity benefits to female employees in 25 provinces in China, addressing concerns about childbirth among young people [1][2] - The National Healthcare Security Administration (NHSA) is actively promoting a direct payment model for maternity benefits, which reduces the risk of delays or withholding by employers [2][4] Group 1: Maternity Benefits Policy - The average maternity allowance for female employees has exceeded 26,000 yuan, and it can be claimed without a marriage certificate [1][2] - As of November 1, 2023, 25 provinces, including Jiangsu and Liaoning, have implemented direct payment of maternity benefits to individuals, covering nearly 90% of the regions [1][2] Group 2: Simplification of Claim Process - The NHSA has simplified the application process for maternity benefits, with most regions no longer requiring a marriage certificate or other non-essential documents [2][4] - In some areas, mothers can experience "seamless application" for maternity benefits through automated systems, reducing the need for in-person visits [3][4] Group 3: Comprehensive Maternity Support - The NHSA is working to establish a comprehensive maternity support system, enhancing coverage for hospitalization and maternity medical expenses [4] - Seven provinces have achieved a model where childbirth incurs minimal costs, and all provinces have included assisted reproductive services in their insurance coverage [4]

Core Points - The national medical insurance bureau is accelerating the establishment of a comprehensive fertility protection system to support childbirth and child-rearing [1] - As of the end of October, all 31 provinces and Xinjiang Production and Construction Corps have included assisted reproduction in medical insurance, benefiting over 1 million people [1] - 25 provinces have implemented direct payment of maternity benefits to individuals, enhancing convenience for insured female employees [2][3] Group 1: Maternity Insurance and Benefits - The maternity allowance, also known as "maternity pay," is funded by maternity insurance, ensuring income security for female employees during childbirth and maternity leave [3] - By June 2025, the number of people covered by maternity insurance reached 253 million, with an average maternity allowance exceeding 26,000 yuan per insured female employee in 2024 [3] - Seven provinces have achieved a model where childbirth incurs minimal out-of-pocket expenses, with reports of individuals spending as little as 3.7 yuan for hospital delivery [4] Group 2: Direct Payment and Accessibility - The transition to direct payment of maternity benefits has streamlined the application process, eliminating the need for additional documents like marriage and birth certificates [3] - In Xiangtan, Hunan Province, the maternity allowance will be directly deposited into personal accounts starting January 2025, reducing processing time from 20 to 7 working days [2] - The implementation of real-time reimbursement policies for newborns has significantly eased financial burdens for new parents [4] Group 3: Inclusive Coverage - Flexible employment insurance participants will also enjoy equal maternity benefits starting November 1, 2025, ensuring broader access to maternity care [5] - The integration of medical and educational services for infants is being promoted, with cities like Meishan in Sichuan establishing public childcare institutions that combine health care and early childhood education [6]

Core Points - The National Medical Insurance Administration is accelerating the establishment of a comprehensive maternity insurance system to support childbirth and child-rearing [1][3] - As of the end of October, all 31 provinces and Xinjiang Production and Construction Corps have included assisted reproduction in medical insurance, benefiting over 1 million people [1] - The direct payment of maternity benefits to individuals has been implemented in 25 provinces, enhancing convenience for insured female employees [3][11] Group 1: Maternity Insurance System - The maternity insurance system now includes flexible employment workers, migrant workers, and new employment forms, with a focus on improving prenatal care benefits [1][3] - The average maternity benefit for insured female employees is over 26,000 yuan as of 2024 [13] - Seven provinces have achieved a model where childbirth incurs minimal costs for families [14] Group 2: Direct Payment of Maternity Benefits - The direct payment of maternity benefits to individuals has streamlined the process, reducing the need for additional documentation such as marriage and birth certificates [11][13] - In Xiangtan, the maternity benefit process has been expedited from 20 working days to 7 working days, with 2,500 female employees benefiting from this service in 2025 [7][9] - The direct payment system helps alleviate financial pressure on new parents and prevents employers from delaying or withholding benefits [9][11] Group 3: Childcare and Health Services - The development of a childcare service system has increased the number of childcare spots for children under three years old from 1.8 to over 4 per thousand population [23] - Sichuan's Meishan has established public childcare institutions that integrate medical and educational services for infants [25] - The integration of traditional Chinese medicine into childcare practices is being implemented in various childcare centers [26]