1. Special medical expenses include organ and tissue transplantation due to illness, organ and tissue purchase and use of anti-rejection drugs and immunomodulatory drugs beyond the scope of medical insurance reimbursement for Zhenjiang employees;

2. Work-related injuries and occupational diseases;

3. Female workers give birth;

4. Rogue fights;

5. Injuries caused by alcoholism;

6. Traffic accidents;

7. Others intentionally hurt;

8. Medical malpractice;

9. Beauty and health examination;

10, other expenses not paid by the social medical insurance fund.

The scope of reimbursement is:

1, drug cost: auxiliary examination: 200 yuan for ECG, X-ray fluoroscopy, photography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetic resonance; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).

2. The elderly over 60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

Town risk fund compensation, all inpatients who participate in rural cooperative medical insurance should declare medical expenses exceeding 5,000 yuan at one time or within one year, that is, 5001-kloc-0/0000 yuan is 65%, and10001-kloc-0/8000 yuan is 75%.

legal ground

People's Republic of China (PRC) Social Insurance Law Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance to protect citizens' right to get material help from the state and society in the event of old age, illness, industrial injury, unemployment and maternity. Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.