1, did not see a doctor in a designated hospital. Medical insurance cards can only be used in designated hospitals, and medical insurance will be reimbursed. Medical insurance will not be reimbursed for not seeing a doctor in a designated medical institution. Moreover, the higher the level of hospital treatment, the lower the reimbursement ratio. In addition, the reimbursement limit is exceeded. After the unification of medical insurance for urban and rural residents, the real-time reimbursement of medical expenses has been realized, and the reimbursement ratio is still the same as before, but the accumulated reimbursement amount for one year is limited.
2. Special medical care. Medical expenses for traffic accidents or work-related injuries due to personal reasons shall not be reimbursed; Medical expenses caused by drunk driving, drug abuse, theft and other reasons will not be reimbursed by medical insurance; Medical expenses caused by abortion and abortion due to personal reasons shall not be reimbursed by medical insurance; Medical expenses caused by plastic surgery, beauty, weight loss and other reasons will not be reimbursed by medical insurance.
3. Special treatment. Some medical projects will have special medical project funds, such as children's vaccines, and some related institutions will vaccinate children for free. If parents take their children for vaccination at their own expense, it is not within the scope of medical insurance reimbursement, and medical insurance will not be reimbursed. The above is the scope that medical insurance cannot reimburse. Everyone must understand the scope of medical insurance reimbursement and avoid unnecessary trouble when reimbursement.
Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations.