(The answer is transferred from Hubei Paper Circuit)
Medical insurance shall not be paid in the following circumstances
1. See a doctor in a non-designated medical institution (except emergency) or buy medicine in a non-designated retail pharmacy;
2. Self-injury caused by fighting, drug abuse or other illegal acts;
3 because of alcoholism, suicide, self-harm and other reasons to receive treatment;
4. Injuries caused by traffic accidents, medical accidents or other accidents;
5. Receiving treatment abroad or in Hongkong, Macao Special Administrative Region and Taiwan Province Province;
6 according to national or local regulations should be paid by individuals.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.