According to the relevant provisions of the national medical insurance, self-seeking medical treatment (no designated hospital for medical treatment or no referral form), self-purchased drugs, drugs that cannot be reimbursed according to the provisions of public medical care, and medical expenses that do not conform to family planning; Outpatient treatment fee, visiting fee, hospitalization fee, meals fee, escort fee, nutrition fee, blood transfusion fee (except for family blood storage, which shall be reimbursed according to relevant regulations), cooling and heating fee, ambulance fee, special nursing fee, etc. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents; The scope of reimbursement for orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consultation fees, etc. exceeds the limit. Not covered by medical insurance reimbursement.

Therefore, we can't generally say that trauma can't be reimbursed, only within the prescribed scope. Those who meet the prescribed conditions can be reimbursed.

Medical insurance reimbursement and subsidy scope:

1, outpatient and emergency medical expenses: the part of the medical expenses of employees who meet the basic medical insurance coverage in the year that exceeds the prescribed amount of 2,000 yuan.

2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.

3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.

4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing. Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.

5. Hospitalization.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.