1. Injuries Caused by Third Parties

Medical expenses incurred from personal injuries attributable to third parties shall be borne by the liable third party and shall not be reimbursed by medical insurance.

2. Work-related Injuries

Expenses for injuries identified as work-related accidents shall be covered by work injury insurance under social insurance, and no duplicate reimbursement will be provided by basic medical insurance.

3. Medical Treatment Outside Chinese Mainland

Medical costs generated from medical treatment in foreign countries, Hong Kong, Macao and Taiwan are not eligible for reimbursement.

4. Public Health Services

Welfare public health services provided by government medical and health institutions for all residents, mainly disease prevention and control services such as infectious disease prevention and health education, are funded by the state and excluded from medical insurance reimbursement.

5. Cosmetic and Plastic Surgery Services

Cosmetic or plastic procedures that do not restore physical body functions shall not be reimbursed by basic medical insurance.

6. General Physical Examinations

Routine health check-ups are not covered by basic medical insurance. Participants covered by Shenzhen Tier 1 medical insurance may use personal medical insurance accounts to pay for physical examinations.