What is the hospitalization medical expenses within or outside social security?

The medical expenses for hospitalization within social security or outside social security refer to the categories that are included in the scope of medical insurance reimbursement according to local medical insurance regulations, while the expenses outside social security may refer to the expenses that are outside the medical insurance catalogue or are not reimbursed.

Social insurance refers to a social and economic system that provides income or compensation for people who lose their ability to work, are temporarily unemployed or suffer losses due to health reasons. The main items of social insurance include endowment insurance, medical insurance, unemployment insurance, industrial injury insurance and maternity insurance. The social insurance plan is organized by the government, forcing a certain group to use part of its income as social insurance tax (fee) to form a social insurance fund. Under certain conditions, the insured can get fixed income or loss compensation from the fund. It is a redistribution system, and its goal is to ensure the reproduction of material and labor and social stability.

In China, social insurance is an important part of the social security system, occupying a core position in the whole social security system. In addition, social insurance is a contributory social security. The funds are mainly paid by employers and workers themselves, and the government finances give subsidies and bear the ultimate responsibility. However, workers can only enjoy the corresponding social insurance benefits if they fulfill their statutory payment obligations and meet the statutory conditions. Social insurance is the most important part of the social security system. Therefore, when discussing the history of social insurance, social insurance cannot be separated from social security.

"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:

1. paid from the industrial injury insurance fund;

Second, it shall be borne by the third party;

Third, it should 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.