The Social Security Board (SSB) has changed how it calculates and how it reimburses maternity costs incurred at private medical facilities. This is applicable for all workers insured under Myanmar’s social security scheme. Changes to maternity entitlements, result from Directive No (7) 2021 issued by the SSB on 7 December 2021 with letter No.0905/3/LaMaPha(Med)2021(10927) (Directive).
Prior to the Directive coming into force, an insured woman at the time of delivery is entitled to 50% of her average monthly wages received over the last 12 months for the delivery of one child; 75% of average monthly wages for twins; and 100% of average monthly wages for triplets. It should be noted that the SSB has set a maximum wage rate to be used when assessing both contributions and entitlements as MMK 300,000. Meaning that an insured woman is entitled to MMK150,000 for giving birth of one child, MMK 225,000 for twins and the full MMK 300,000 for triplets, assuming that the mother was paying contributions based on an income of MMK 300,000 per month (the maximum).
The new Directive sets reimbursement entitlements for maternity costs at a private hospital. The determining factors for the level of entitlement is no longer the number of children delivered and the level of previous contributions, but is now based on the type of procedures required. The rates are as follows:
MMK 300,000 for natural delivery;
MMK 550,000 for caesarean delivery;
MMK 280,000 for miscarriage;
MMK 320,000 for forceps or vacuums delivery; and
MMK 500,000 for ectopic pregnancy
The above entitlements, which apply only to private medical services, have become applicable as of 1 December 2021. Note that there is no change for receiving maternity services at public medial facilities where all costs remain covered.
Two key changes under the new entitlement scheme is that entitlement costs are now closer aligned to the costs associated with the procedure (although in most cases still only covering a portion of the costs) and that it is no longer based on salary.
The Directive further clarifies that insured workers will continue to receive medical benefits as before for conditions not directly related to the delivery, such as chronic diabetes, high blood pressure and blood disease. Additional entitlements also are provided for post maternity problems such as placenta accreta and excessive bleeding and for providing a blood transfusion, these are not changed by the Directive.
Other maternity benefits
Other than providing for coverage of medical expenses, insured workers are entitled to other benefits which remain unchanged under the Directive.
As per the Social Security Rules, during maternity leave the insured person is entitled to receive 70% of their average salary. Note that this is also capped at a maximum assessable salary of MKK300,000 per month, meaning the maximum benefit is MMK 210,000 per month.
While this is the maximum benefit which an insured individual may receive from the SSB. It should be noted that employers are obliged under the Leave and Holidays Act to pay their employees a full salary during their maternity leave. They employer is however allowed to offset from wages the benefit received from the SSB.