上海市医保局于2026年9月8日发布生育医疗费用保障新政，将产检和分娩的保障方式从"先自付后补贴"改为"个人无自付"，合规生育医疗费用由生育保险全额支付。1 新政自2026年10月1日起施行，有效期至2031年9月30日。1
根据新政，产检费用补贴额度为每人4500元，覆盖范围从建卡到产后42天康复检查。1 即使补贴额度用完，后续医疗费用仍由生育保险继续全额支付。1 住院分娩政策范围内的费用也实现全免。1 这一政策旨在应对上海高龄孕妈增加和低生育率现象，减轻生育家庭的医疗经济负担。1 全国已有28个省份实现政策范围内住院分娩个人"无自付"。1 2025年上海户籍人口总和生育率仅为0.66。1
Shanghai's municipal medical insurance bureau unveiled a new policy on September 8, 2026, fundamentally restructuring how prenatal and delivery expenses are covered 1. Rather than requiring residents to pay upfront and seek reimbursement, the revised system ensures that all eligible reproductive healthcare costs are fully covered by maternity insurance with zero out-of-pocket expenses for patients 1. The policy takes effect on October 1, 2026, and remains valid through September 30, 2031 1.
Under the new framework, prenatal check-ups receive a designated subsidy of 4,500 yuan per person, with maternity insurance covering all additional costs beyond this amount 1. The coverage spans from initial pregnancy registration through the 42-day postpartum recovery examination 1. Hospital delivery charges within the policy scope are entirely covered by insurance, eliminating personal financial burden at point of service 1. This reform directly addresses Shanghai's demographic challenges, where the total fertility rate among registered residents stood at 0.66 in 2025, alongside the rising proportion of advanced-age pregnancies 1.
The initiative positions Shanghai alongside 28 other provinces nationwide that have already achieved zero out-of-pocket expense policies for hospital deliveries covered under maternity insurance schemes, as of September 4, 2026 1.
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