(1) Those that should be paid from the industrial injury insurance fund. According to Article 64 of the Social Insurance Law, which stipulates that "each social insurance fund shall keep separate accounts in accordance with the type of social insurance", medical expenses that should be paid out of the Industrial Injury Insurance Fund cannot be included in the scope of payment of the Basic Medical Insurance Fund.
(2) should be borne by a third party. The medical expenses incurred by the insured person due to personal injury caused by a third person shall be borne by the third person.
(3) Should be borne by public **** health. Basic public **** health services are provided free of charge to urban and rural residents on a project-by-project basis, and the funding standard is approved on the basis of the comprehensive cost of the services per unit, and the required funding is arranged by the government budget.
(4) Medical treatment outside the country. Medical expenses for medical treatment outside the country are not included in the scope of payment by the basic medical insurance fund.
Medical expenses shall be borne by a third party in accordance with the law, and if the third party fails to pay or if the third party cannot be identified, the basic medical insurance fund shall pay in advance. The basic medical insurance fund shall have the right to recover the costs from the third party after paying the costs first.
Expanded information:
The Social Insurance Law of the People's Republic of China*** and the State of China was formulated to regulate social insurance relations, safeguard the legitimate rights and interests of citizens in participating in social insurance and enjoying social insurance benefits, and to enable citizens*** to enjoy the fruits of development and promote social harmony and stability.
Adopted at the Seventeenth Meeting of the Standing Committee of the Eleventh National People's Congress on October 28, 2010, it was promulgated by Decree No. 35 of the President of the People's Republic of China*** and the State of China on October 28, 2010, and shall come into force on July 1, 2011.
The Decision of the Standing Committee of the National People's Congress on Amending the Social Insurance Law of the People's Republic of China has been adopted by the Seventh Meeting of the Standing Committee of the Thirteenth National People's Congress of the People's Republic of China on December 29, 2018, and is hereby promulgated to come into force as of the date of promulgation.
The full text of the latest social insurance law includes twelve chapters and ninety-eight articles, including the general provisions, basic pension insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, collection of social insurance premiums, social insurance fund, social insurance administration, supervision of social insurance, legal responsibility, and bylaws***.