After assisted reproduction was covered by health insurance, another often confused concept emerged: maternity insurance. Many customers ask, "Can assisted reproduction be covered by maternity insurance?" "How do I receive benefits after giving birth?" This article uses the Beijing insurance policy as an example to clarify the relationship between the two systems and how they are connected, helping you avoid misunderstandings.

1. Maternity insurance and health insurance are two different things

Basic health insurance covers costs related to treatment, such as egg retrieval and transplantation procedures;
Maternity insurance covers benefits related to childbirth, maternity leave, and allowances. It is usually provided by employers and has nothing to do with whether the pregnancy was achieved through assisted reproduction.

In short, the costs of assisted reproduction treatments are covered by health insurance, while benefits after childbirth are covered by maternity insurance. The two systems operate independently.
For example, in Beijing's employee insurance system, these two types of insurance are managed by separate funds. There are no shared settlement channels or reimbursement rules between them. Health insurance is paid jointly by individuals and employers, covering medical expenses related to diseases. Maternity insurance is paid only by employers, with no costs borne by individuals. It provides benefits related to childbirth and income compensation.

2. Assisted reproduction procedures are generally covered by health insurance

As mentioned earlier, egg retrieval, embryo culture, and transplantation are already covered by basic health insurance (the list and percentages vary from place to place). These procedures are not part of traditional maternity insurance's coverage for childbirth-related medical expenses. Instead, they are treated as medical services under health insurance.

In Beijing, currently, 16 therapeutic assisted reproduction techniques are covered by basic health insurance. This includes vaginal egg retrieval, embryo transfer, and blastocyst culture. When seeking treatment at approved assisted reproduction institutions in Beijing, costs that meet clinical criteria can be settled directly using outpatient health insurance policies. This does not affect the benefits provided by maternity insurance.

3. After the baby is born, maternity insurance still applies

Whether the child is born through natural conception or assisted reproduction, as long as the individual meets the requirements for participating in and paying for maternity insurance, they can normally enjoy all the benefits of maternity insurance, including reimbursement for hospital costs during childbirth, maternity allowances, legal maternity leave and extended paternity leave, etc. The method of conception does not affect the eligibility for these benefits.

4. Important details to note regarding the transition between the two systems

• Continuity of payments: Maternal insurance usually requires continuous payment for a certain number of months before childbirth. It's important to note this requirement when changing jobs or missing out on payments for some time.
  For example, in Beijing, to claim maternity benefits, it's required to have paid into the maternal insurance system continuously for at least 9 months before childbirth (including the month of childbirth itself). If the payment period before childbirth is insufficient, the benefits must be paid by the employer first. After 12 consecutive months of payment after childbirth, the maternal insurance fund will cover the remaining amount. It's advisable to avoid missing out on social security payments during periods of job change.
• Birth in another location: Rules for settling maternity insurance claims vary from place to place.
  For example, in Beijing, if you choose to give birth in a hospital outside of Beijing, medical expenses cannot be settled directly using credit cards. You need to keep all relevant documents such as receipts, expense details, and diagnosis certificates. Your employer will then handle the reimbursement process at the local medical insurance agency. The reimbursement standards still follow the payment scope and limits set by Beijing's maternal insurance regulations.
• Policy differences: Different provinces have different standards and procedures for claiming benefits. It's necessary to check the local regulations.
  Even in cities where assisted reproduction is covered by healthcare insurance, there are still regional differences in payment thresholds, calculation methods for benefits, and maternity leave durations. Please refer to the latest official policies of your local area for specific rules.

5. Recommendations from Leilawa

Separate the calculations for "treatment costs" and "maternity benefits". For treatment costs, consult with the healthcare insurance department (for assisted reproduction-related expenses). For benefits, contact the maternal insurance department (for maternity leave/ benefits). Check both aspects before seeking medical treatment so that your budget and rights are clearly understood.
For families enrolled in Beijing's healthcare insurance system, it's recommended to verify the list of eligible expenses for assisted reproduction through Beijing's official healthcare insurance channels. Also, confirm with your employer the duration of payments and the procedures for claiming benefits. By separating these two aspects, you can avoid misunderstandings and unexpected discrepancies during the treatment process.