1. If the work-related injury involves a third party, the medical expenses shall be borne by the third party, and the basic medical insurance fund shall not reimburse it;

2, if the third party is unable to compensate, the basic medical insurance fund can advance, and then have the right to recover from the third party;

3. If the responsibility of the third party is clear, but it has been reimbursed through medical insurance, the insurance foundation will recover the expenses;

4, the basic medical insurance fund does not pay the medical expenses that the third party should be responsible for, the expenses that the industrial injury insurance fund should pay, the expenses that should be borne by public medical care, and the expenses of going abroad for medical treatment.

Reimbursement scope of medical insurance:

1. Drug expenses: western medicine and Chinese patent medicine are included in the medical insurance catalogue;

2. Cost of diagnosis and treatment items: covering items such as examination, treatment and surgery in the medical insurance catalogue;

3. Medical service fees: basic medical service fees such as registration fees and bed fees;

4. Special material cost: refers to the cost of high-value medical consumables stipulated by medical insurance;

5. Chinese medicine treatment expenses: including acupuncture, massage and other Chinese medicine treatment methods.

The above expenses can be reimbursed only if they are treated in the designated medical institutions of medical insurance and meet the requirements of medical insurance policies.

To sum up, the basic medical insurance fund does not reimburse the medical expenses related to the third party's liability, but can advance and recover the expenses. If it has been reimbursed through medical insurance, the cost will be recovered. In addition, the basic medical insurance fund does not pay third-party liability, industrial injury insurance fund, public health expenses and overseas medical expenses.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 30

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.