According to the Municipal Healthcare Bureau, in order to advance universal enrollment, safeguard the maternity insurance rights of freelance workers, and ensure the seamless integration of maternity allowances with maternity medical benefits, the city has recently formulated the "Notice on Matters Concerning Freelance Workers' Entitlement to Maternity Allowances." The notice stipulates that effective May 1, 2027, freelance workers' maternity allowances will be enjoyed in sync with their basic employee medical insurance benefits. A transitional period has been established, and the eligibility criteria differ between the transitional period and the formal implementation phase. Below is a detailed explanation.
What is the main purpose of this Notice?
To implement the relevant provisions of the "Medical Security Law of the People's Republic of China" regarding citizens' lawful enrollment in insurance and their entitlement to basic medical security and maternity insurance benefits, to solidly advance universal enrollment and ensure coverage for all who are eligible, and to further standardize the rules governing maternity insurance benefits for freelance workers, this Notice has been formulated.
What do maternity insurance benefits primarily include?
Maternity insurance benefits consist of two components: maternity allowances and maternity medical expenses. The maternity allowance serves as substitute income protection for female employees during maternity leave, ensuring their basic livelihood during that period. Maternity medical expenses cover the basic medical needs of women during childbirth, primarily including the "Maternity Insurance Basic Healthcare Service Package" and the "zero out-of-pocket" benefit for policy-covered inpatient delivery medical costs in this city.
How is the waiting period for freelance workers enrolling in the city's basic employee medical insurance applied?
For freelance workers enrolling in the city's basic employee medical insurance, the benefit waiting period is 6 months. Those who make continuous full contributions for 6 months and continue to make normal contributions thereafter will enjoy employee medical insurance benefits starting from the following month. If contributions are interrupted during the waiting period, the waiting period will be recalculated. If in-service employees or urban-rural residents who have stopped receiving employee medical insurance or resident medical insurance benefits enroll in employee medical insurance as freelance workers within 3 months and pay contributions normally, the aforementioned waiting period rules shall not apply.
What conditions must freelance workers meet to apply for maternity allowances?
The policy is implemented in two phases: a transitional period and a formal implementation phase. During the transitional period (before April 30, 2027), those who are enrolled and contributing as freelance workers in the month of childbirth or miscarriage, and who have accumulated at least 12 months of contributions to the city's basic employee medical insurance before the childbirth or miscarriage, may apply for maternity allowances in accordance with regulations. Being in the employee medical insurance waiting period at the time of childbirth or miscarriage does not affect the application for maternity allowances. Under the formal implementation of the new policy (from May 1, 2027), applicants must simultaneously meet two conditions: first, they must be normally enjoying basic employee medical insurance benefits at the time of childbirth or miscarriage; second, they must have accumulated at least 12 months of contributions to the city's basic employee medical insurance before the childbirth or miscarriage. Those in the employee medical insurance waiting period at the time of childbirth or miscarriage shall not be entitled to maternity allowances.
Note: During the transitional period, whether one is in the medical insurance waiting period is not considered. As long as the person is enrolled and contributing normally in the current month and has accumulated at least 12 months of contributions before childbirth or miscarriage, they can apply for the allowance. After May 1, 2027, the person must already be able to normally use employee medical insurance at the time of childbirth, and childbirth during the waiting period will no longer qualify for maternity allowances.
What are the conditions for freelance workers to receive maternity medical expense benefits?
The recently issued "Notice on Further Improving Maternity Medical Expense Protection Policies in This City" has clarified that maternity medical expense benefits are enjoyed in sync with basic medical insurance benefits. Freelance workers who normally enjoy employee medical insurance benefits may receive the "zero out-of-pocket" benefit for maternity medical expenses. Those who give birth during the medical insurance waiting period shall not receive the "zero out-of-pocket" benefit for maternity medical expenses and cannot apply for the settlement of the remaining balance of maternity medical expense subsidies.
To ensure a smooth transition, a transitional period has been set from October 1, 2026, to April 30, 2027. For childbirth during the transitional period, if the person is enrolled and contributing as a freelance worker in the month of childbirth and has accumulated at least 12 months of contributions to the city's employee medical insurance, even if they are in the employee medical insurance waiting period at the time of childbirth, they may still process the settlement of the remaining balance of maternity medical expense subsidies in accordance with regulations. From May 1, 2027, freelance workers who are in the employee medical insurance waiting period at the time of childbirth will neither receive the "zero out-of-pocket" benefit for maternity medical expenses nor be able to process the settlement of the remaining balance of maternity medical expense subsidies.
If already pregnant and enrolled in employee medical insurance as a freelance worker, can one receive maternity insurance-related benefits?
Benefit entitlement is determined based on the timing of childbirth in different scenarios:
01 For childbirth before April 30, 2027: If the person is enrolled and contributing as a freelance worker in the month of childbirth and has accumulated at least 12 months of contributions to the city's employee medical insurance before delivery, they may apply for maternity allowances in accordance with regulations.
02 For expected delivery in May 2027 or later: The person must have been continuously and normally enrolled and contributing as a freelance worker since October 2026, normally enjoy employee medical insurance benefits, and have accumulated at least 12 months of contributions to the city's employee medical insurance before delivery to be eligible to apply for maternity allowances in accordance with regulations. If contributions are interrupted and the person is still in the employee medical insurance waiting period at the time of childbirth, they shall not receive maternity allowances or maternity medical expense-related benefits.
Note: Freelance workers should ensure timely enrollment and continuous contributions, avoiding lapses in coverage, to fully enjoy all basic medical insurance and maternity insurance benefits.
If an in-service employee plans to resign before giving birth and subsequently enrolls as a freelance worker, how are maternity insurance benefits handled?
If an insured person enrolls in employee medical insurance as a freelance worker within 3 months after their employee medical insurance benefits are interrupted, they are not subject to the 6-month waiting period rule for employee medical insurance. If they directly transition from post-resignation to freelance enrollment, or transition to freelance enrollment immediately after their unemployment insurance benefits expire, they may normally enjoy maternity medical expense benefits. On this basis, if they have accumulated at least 12 months of contributions to the city's employee medical insurance before childbirth or miscarriage, they may apply for maternity allowances in accordance with regulations.
For those enrolled in resident medical insurance who switch to employee medical insurance as freelance workers, how are maternity insurance benefits applied?
If an insured person is normally enrolled in resident medical insurance at the time of childbirth or miscarriage, they may enjoy maternity medical expense benefits in accordance with regulations, but resident medical insurance enrollees are not entitled to maternity allowances. For those originally enrolled in resident medical insurance who enroll in employee medical insurance as freelance workers within 3 months after their medical insurance benefits are interrupted, the waiting period rules shall not apply. If they are already normally enjoying employee medical insurance benefits at the time of childbirth or miscarriage, they may enjoy maternity medical expense-related benefits. If they have accumulated at least 12 months of contributions to the city's employee medical insurance before childbirth or miscarriage, they may apply for maternity allowances in accordance with regulations.
Friendly reminder: Freelance insured persons should plan their enrollment timing reasonably, pay contributions on time and in full, and avoid lapses that could affect their entitlement to maternity-related benefits. For further questions, you may consult online via the "Shanghai Healthcare Digital Assistant" or call the healthcare consultation hotline at 12393.
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