The items that are not included in the fund medical care are:

1. Those that should be paid from the industrial injury insurance fund;

2. It shall be borne by a third party;

3. It should be borne by public health;

4. seeking medical treatment abroad.

5. Medical expenses beyond the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards;

6. Other expenses not paid as stipulated by the state and the autonomous region.

7, sports and fitness, health care consumption, health check-ups are not reported. Medical insurance refers to the need for medical treatment due to the risk of illness/accident, so whether it is physical fitness, physical examination or health care, it does not belong to the treatment category, so it will not be reimbursed.

the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.

From the above, it can be seen that overseas medical treatment; Belonging to the responsibility of a third party; Physical fitness, health care consumption, health examination, etc.; Industrial accidents; Public health services; Drugs, facilities and projects within the scope of non-medical insurance catalogue are not included in the fund medical care projects.

Legal basis:

Article 3 of the Social Insurance Law

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

(1) Those that should be paid from the work injury insurance fund;

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

(3) It shall be borne by public health;

(4) seeking medical treatment abroad.

the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.