Is there any medical insurance reimbursement for accidental falls?

Accidental injury is not covered by medical insurance.

Legal analysis: The basic medical insurance is an important part of the social security system, and it is a kind of social insurance formulated by the government with the participation of employers and employees. It is based on the affordability of employers and employees to determine everyone's basic medical security level.

It is universal, economical and compulsory. Basic medical insurance is the basis of medical security system. The basic medical needs of the insured can be guaranteed by the principle that both employers and employees share the burden, pay jointly, plan as a whole in the city and combine individual accounts with the overall fund. Mainly used to pay for general outpatient, emergency and hospitalization expenses. The basic medical insurance premium shall be paid by the employer and individual employees.

Basic medical insurance reimbursement scope:

The basic medical insurance co-ordination fund and individual account shall delimit their respective payment scope and be accounted for separately. Medical expenses that meet the payment scope of the basic medical insurance fund shall be reimbursed in accordance with the list of basic medical insurance drugs, the list of diagnosis and treatment items, the scope of service facilities and the payment standard stipulated by this Municipality.

Personal account to pay the following medical expenses:

Outpatient and emergency medical expenses; The cost of purchasing drugs at designated retail pharmacies; Medical expenses below the Qifubiaozhun of the basic medical insurance pooling fund; Medical expenses that exceed the qifubiaozhun of the basic medical insurance pooling fund and should be borne by individuals in proportion. The insufficient part of personal account shall be paid by myself.

The basic medical insurance fund pays the following medical expenses:

Hospitalization medical expenses; Emergency rescue observation and income hospitalization, medical expenses within 7 days before hospitalization observation; Outpatient medical expenses of taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis and renal transplantation for malignant tumors.

The basic medical insurance fund shall not pay the following medical expenses:

See a doctor in a non-designated medical institution, except for emergency; Buying drugs at non-designated retail pharmacies; Injuries caused by traffic accidents, medical accidents or other accidents; Drug abuse, fighting or other illegal acts cause injuries; Treatment for suicide, self-mutilation, alcoholism and other reasons; Treatment abroad or in Hongkong, Macao Special Administrative Region and Taiwan Province Province; In accordance with the provisions of the state and this Municipality, it shall be paid by individuals.

The medical expenses incurred by enterprise employees due to work-related injuries and occupational diseases shall be implemented in accordance with the relevant provisions of work-related injury insurance. The medical expenses for the birth of female employees shall be implemented in accordance with the relevant provisions of the state and this Municipality.

Legal basis: Article 26 of the Social Insurance Law, the treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(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.