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Why do you have to pay for surgery yourself when you have health insurance?

Legal analysis: Self-funded medicine is the part paid by oneself, and it is impossible to report it if it does not meet the scope of national reimbursement, and half of it is self-funded medicine. Social security and medical insurance are first deducted from the deductible, then deducted from the self-funded and self-funded parts, and then reimbursed in proportion.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) shall be paid by the industrial injury insurance fund (2) shall be borne by a third party (3) shall be borne by public medical care (4) overseas medical care.

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.

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