医疗保险报销注意！这六种状况不报销
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">（<span style="color: black;">源自</span>：黑龙江省残联）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">医疗保险</span><span style="color: black;">始终</span>是人们比较关心的<span style="color: black;">专题</span>，<span style="color: black;">咱们</span><span style="color: black;">平常</span>的买药、看病都离不开<span style="color: black;">医疗保险</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">但<span style="color: black;">实质</span><span style="color: black;">运用</span>过程中，有不少小伙伴对<span style="color: black;">医疗保险</span>的报销范围<span style="color: black;">不足</span><span style="color: black;">认识</span>，<span style="color: black;">引起</span><span style="color: black;">花费</span><span style="color: black;">没</span>法报销。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">那样</span>，<span style="color: black;">那些</span><span style="color: black;">花费</span><span style="color: black;">医疗保险</span><span style="color: black;">不可</span>报？<span style="color: black;">那些</span><span style="color: black;">花费</span>又是<span style="color: black;">医疗保险</span>能够报销的呢？</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">博主</span><span style="color: black;">已然</span>为<span style="color: black;">大众</span>整理好了，<span style="color: black;">一块</span>来看！</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q2.itc.cn/q_70/images03/20240426/a4b6db26f35949d58eb059b254a430a8.gif" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">这六种<span style="color: black;">状况</span>，<span style="color: black;">医疗保险</span>不报销</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">1、</span>工伤事故不报</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">倘若</span>在工作中<span style="color: black;">出现</span>事故，被认定为工伤的，应由社会保险中的工伤保险承担，<span style="color: black;">医疗保险</span><span style="color: black;">再也不</span>重复报销</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">2、</span>第三方责任不报</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">由第三方<span style="color: black;">原由</span><span style="color: black;">引起</span>且因第三方负责的<span style="color: black;">状况</span>，所产生的医疗<span style="color: black;">花费</span>等，<span style="color: black;">医疗保险</span>不报。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">如交通事故、打架斗殴等，其产生的医疗<span style="color: black;">花费</span>由<span style="color: black;">关联</span>的责任人来承担，那<span style="color: black;">详细</span>责任人则由<span style="color: black;">关联</span><span style="color: black;">分部</span>/<span style="color: black;">公司</span>来认定，<span style="color: black;">例如</span>交警方/民警方等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">倘若</span>不是第三方全责，先由第三方责任人按规定予以赔偿，剩余部分<span style="color: black;">医疗保险</span>按规定补差。<span style="color: black;">倘若</span><span style="color: black;">不可</span><span style="color: black;">知道</span>第三方的身份，<span style="color: black;">或</span>产生第三方逃逸/不承担责任的<span style="color: black;">状况</span>，<span style="color: black;">医疗保险</span>基金可先做报销处理，再找第三方进行追责。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">3、</span>非<span style="color: black;">医疗保险</span>目录不报</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">基本<span style="color: black;">医疗保险</span><span style="color: black;">保证</span>的是<span style="color: black;">基本</span>医疗需求，<span style="color: black;">因此</span>是有<span style="color: black;">必定</span>限制的，<span style="color: black;">例如</span>除了“起付线和封顶线”，还有专门设定了<span style="color: black;">医疗保险</span>的三大目录。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">只要是在三大目录以外的<span style="color: black;">药物</span>、医用耗材、项目等，<span style="color: black;">医疗保险</span>均不报销。<span style="color: black;">因此</span>在<span style="color: black;">医疗保险</span>目录以外的医疗<span style="color: black;">花费</span>，如整形、美容、<span style="color: black;">瘦身</span>等产生的医疗<span style="color: black;">花费</span>，<span style="color: black;">医疗保险</span>不予报销。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">4、</span>公共卫生服务不报</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">由医疗卫生<span style="color: black;">公司</span>向全民<span style="color: black;">供给</span>的预防、<span style="color: black;">掌控</span><span style="color: black;">疾患</span>的公益性服务，<span style="color: black;">例如</span>一类疫苗接种、传<span style="color: black;">患病</span>防治、健康教育等，这些基本<span style="color: black;">是由于</span>国家公共卫生<span style="color: black;">花费</span>支付，<span style="color: black;">因此</span><span style="color: black;">医疗保险</span>就不报销了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">5、</span>境外<span style="color: black;">看病</span>不报</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">针对境外<span style="color: black;">看病</span>所产生的医疗<span style="color: black;">花费</span>，<span style="color: black;">医疗保险</span>是不予报销的。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">6、</span>非<span style="color: black;">选定</span>医疗<span style="color: black;">公司</span><span style="color: black;">看病</span>不报</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在非<span style="color: black;">医疗保险</span><span style="color: black;">选定</span>医疗<span style="color: black;">公司</span><span style="color: black;">出现</span>的医疗<span style="color: black;">花费</span>（除急诊外），<span style="color: black;">医疗保险</span>不予报销。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">大众</span>在<span style="color: black;">实质</span><span style="color: black;">运用</span>时</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">重视</span>以上6种<span style="color: black;">状况</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">避免<span style="color: black;">因此呢</span>带来不必要的麻烦</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">往期回顾</strong></p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">源自</span>：中国医疗保险</strong></p>
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