Accidental injury medical insurance cannot be reimbursed. According to national regulations, the medical expenses caused by accidental injuries are not within the reimbursement scope of residents' medical insurance and urban workers' medical insurance. Whether accidental injuries can be included in the scope of medical insurance is a question that the government and relevant units have been thinking and exploring.

Medical insurance reimbursement scope:

(1) service items

1, registration fee, out-of-hospital consultation fee, medical record fee, etc.

2. Special medical services such as visiting fees, urgent fees for examination and treatment (except for emergency), surcharge for name calling operation, high quality and good price, and special care by oneself.

(2) Non-disease treatment projects

1, various beauty (life beauty, medical beauty) bodybuilding projects and disorderly non-functional plastic surgery, orthopedic surgery, etc. ;

2. Various weight loss, weight gain and height increase projects;

3. Various health checks;

4, all kinds of prevention and health care projects;

(3) Diagnostic equipment and medical materials.

1, a project for examination and treatment with large medical equipment such as positron emission tomography, electron beam CT and ophthalmic excimer laser therapeutic apparatus;

2, glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation equipment;

3, all kinds of self-use health care, massage, rehabilitation and treatment equipment.

(4) Treatment items

1, the organ source or tissue source of various organ transplants or tissue transplants;

2. Transplantation of organs or tissues other than kidneys, heart valves, corneas, skin, blood vessels, bones and bone marrow;

3. Orthopedic surgery for myopia;

4, Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.

(5) Others

1, various infertility (pregnancy) and sexual dysfunction diagnosis and treatment projects;

2, all kinds of scientific research, clinical verification of diagnosis and treatment projects.

legal ground

"People's Republic of China (PRC) social insurance law" thirtieth the following medical expenses are not included in the scope of payment of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment. Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.