1, self-medical treatment (without designated hospitals or without referral orders), self-purchased medicines, medicines that cannot be reimbursed under the public medical care regulations and medical expenses that do not comply with family planning;
2, outpatient treatment, consultation fees, hospitalization fees, meals, companion fees, nutritional fees, blood transfusion fees (except for those who have family blood reserves, which are reimbursed according to the relevant regulations), heating and cooling fees, ambulance fees and other expenses such as special Other expenses such as nursing fees;
3. Medical expenses for car accidents, fights, suicides, alcoholism, workplace accidents and medical malpractice;
4. Orthopedics, plastic surgery, dentures, prosthetics, organ transplants, named surgery fees, consultation fees, etc.;
5. Reimbursement of expenses within the scope of reimbursement, but outside the limit.
Expanded Information
Other expenses not covered by the Social Medical Insurance Fund.
1. When an insured employee is on a business trip or visiting relatives abroad and incurs medical expenses, he/she will only be reimbursed for the expenses incurred for emergency treatment abroad in accordance with the provisions of the medical insurance scheme, and will not be reimbursed for any expenses incurred for hospitalization for reasons other than emergency treatment.
2. If an insured employee resides abroad for more than 6 months, he/she will be reimbursed for the medical expenses according to the nature of the long-term resident.
3. Long-term residents should be certified by their units, identify two designated hospitals (which should be local medical insurance designated medical institutions), and promptly apply for the "Zhenjiang City Long-term Resident Medical Expense Reimbursement Card".
4, long-term resident workers must adhere to the principle of savings in accordance with the provisions of the limited number of prescriptions (each visit, the amount of acute medication within 3 days, the amount of chronic disease medication within 10 days, tuberculosis, hypertension, diabetes can be extended to 30 days of the amount of), more than the above standards, the drug costs will not be reimbursed.
5, long-term resident field workers referral, need to be signed by the local designated hospital, according to the principle of local referral level by level, referral hospitals are the city's employee health insurance to determine the special hospital. Individuals first pay 10% of the total cost, and then reimbursement of costs in accordance with the provisions of health insurance, other hospitals, individuals first pay 20% of the total cost, and then reimbursement of medical costs in accordance with the provisions of health insurance.
Baidu Encyclopedia-Medicare Reimbursement Scope