Src = "/zhidaopic/20230210/Hu Zhi/399146bc7c9427ecc62172d22c61E9F9.jpg"/>; Expenses not reimbursed by medical insurance

Article 30 of the Social Insurance Law stipulates that:

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Article 16 of the Medical Security Law (Draft for Comment):

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

( 1) ......

(five) physical fitness, health care consumption, health examination;

(6) Other expenses not paid by the basic medical insurance fund stipulated by the state 1. Expenses that should be paid by the industrial injury insurance fund shall not be reimbursed.

Because work-related injuries enjoy medical treatment for work-related injuries, they are reimbursed by work-related injury insurance and do not occupy medical insurance funds.

2. The expenses that should be borne by the third party will not be reimbursed.

For example, in the event of a traffic accident, medical insurance will not bear the responsibility of the third party, otherwise it will cause an unfavorable situation that all medical insurance participants will bear the fault of the third party.

But if the third party has no money to pay or can't find a third party, it can be paid by the medical insurance fund first, and then recovered from the third party.

3. The expenses of public medical care shall not be reimbursed.

Generally speaking, it refers to the free public health services provided by the government for some major health problems of urban and rural residents, such as neonatal disease screening and vaccination.

4. The expenses for going abroad for treatment will not be reimbursed.

For example, expenses incurred in overseas medical treatment, such as traveling abroad, studying and training, visiting relatives and business activities, are not reimbursed by domestic medical insurance, and can be solved by purchasing commercial insurance or participating in medical insurance in the host country.

5, physical fitness, health care consumption, health examination fees will not be reimbursed.

6, the provisions of the state basic medical insurance fund will not pay other expenses.

For example, medical treatment in different places, fighting, alcohol abuse and other expenses that have not been approved by the medical insurance of the insured place.