January 12 (Xinhua) -- According to the official WeChat account of the National Healthcare Security Administration, in order to implement the relevant regulations of the state and Beijing Municipality on improving the system of policies to support childbirth and promoting the construction of a childbirth-friendly society, and to enhance the protection function of maternity insurance and strengthen the role of childbirth support, the Beijing Municipal Healthcare Security Administration, together with the Beijing Municipal Finance Bureau, jointly issued the "Notice on Strengthening the Coverage of Prenatal Examination Expenses in Beijing" (Beijing Healthcare Security Administration Document No. 24 [2025]). Starting from January 1, 2026, the coverage level of prenatal examination expenses for all types of medical insurance participants will be comprehensively improved, actively supporting the construction of a childbirth-friendly society and promoting high-quality population development.
First, the reimbursement standard for prenatal examination expenses under the maternity insurance program has been increased. For female employees participating in Beijing's maternity insurance program, the maximum reimbursement for prenatal examination expenses covered by medical insurance has been increased from the original maximum of 3,000 yuan to 100% reimbursement for expenses up to 3,000 yuan (inclusive) and 30% reimbursement for expenses exceeding 3,000 yuan, with a maximum fund payment of 10,000 yuan.
Second, reimbursement for prenatal check-up medical expenses has been added for three new categories of people: the self-employed, retirees, and insured residents. Specifically, for self-employed individuals participating in Beijing's employee medical insurance and retirees enjoying Beijing's employee medical insurance benefits, prenatal check-up expenses within the scope of medical insurance will be paid by employee medical insurance according to the aforementioned maternity insurance prenatal check-up reimbursement standards. For insured individuals participating in Beijing's resident medical insurance, prenatal check-up expenses within the scope of medical insurance will be paid by resident medical insurance according to the outpatient reimbursement standards. If insured residents incur prenatal check-up expenses at tertiary hospitals, these expenses can be reimbursed together with ordinary outpatient (emergency) medical expenses, with a deductible of 550 yuan, a reimbursement rate of 50%, and a maximum reimbursement of 5,000 yuan.
Third, unemployed spouses of male employees can enjoy reimbursement for maternity insurance medical expenses. Unemployed spouses of male employees participating in Beijing's maternity insurance who have also participated in basic medical insurance can have their maternity medical expenses (including prenatal examinations, hospital delivery, and family planning surgery costs) covered by medical insurance reimbursed by maternity insurance according to the benefit standards for female employees participating in Beijing's maternity insurance.
Following the policy adjustment, reimbursement for prenatal check-up expenses for female employees enrolled in Beijing's maternity insurance has improved significantly, going from being available to being more favorable. Meanwhile, reimbursement for prenatal check-up expenses for self-employed individuals, retirees, and resident medical insurance participants in Beijing has been made available, addressing previous shortcomings in coverage. These combined policies alleviate the burden of prenatal check-up costs, increase maternity insurance support, and promote high-quality population development.
