42 serious illnesses will not require referral papers

People with rare and serious diseases can go directly to specialized medical examination and treatment facilities, which is one of the new regulations of the revised Law on Health Insurance.

Will adjust the list of critical illnesses

According to the regulations on critical illnesses issued by the Ministry of Health, there are currently 42 diseases on this list. Among them, there are some diseases such as: cancer, lupus erythematosus, organ transplant, severe burns, severe traumatic brain injury, multiple sclerosis, heart valve replacement surgery, multiple sclerosis, liver failure, stroke, coma, Alzheimer's disease or dementia, kidney failure, total and permanent disability.

Doctors are taking a scan to diagnose cancer. This is one of the diseases on the list of fatal diseases.

However, according to the Department of Health Insurance (Ministry of Health), the list of critical illnesses has been issued for many years and needs to be adjusted and updated in accordance with the disease model and advances in treatment. The Ministry of Health is drafting a circular to issue a list of critical illnesses, which are illnesses that do not require a referral for treatment, in accordance with the provisions of the revised Law on Health Insurance recently passed by the National Assembly.

Regarding further information about patients being transferred directly to higher-level treatment, the leader of the Health Insurance Department said that diseases that are transferred directly to higher-level treatment are serious diseases and beyond the professional capacity of local medical facilities. Health departments will proactively announce the list of technical services that have not been performed, so that local people are aware.

According to the Department of Health Insurance, the regulation of going straight to specialized facilities helps patients have more convenient access to treatment, especially for most serious illnesses with high costs.

Currently, many patients treated at higher levels must apply for a referral every year, because the referral certificate covered by health insurance expires on December 31. Patients are forced to apply for a referral, which is very difficult, and often requires long distance travel.

Enjoy 100% benefits when crossing the line according to regulations

Regarding the regulation on treatment beyond the prescribed level, which is expected to be applied from 2025, Director of the Department of Health Insurance Tran Thi Trang gave an example: for some rare diseases, diseases that require the use of advanced techniques that cannot be treated at basic hospitals such as district and provincial hospitals, and have not been approved for the list of techniques, people can go directly to specialized facilities, such as the final level hospital, the leading hospital for diagnosis and treatment. At that time, it is still considered to be at the right level of technical expertise, and they will enjoy 100% of the benefits.

According to Ms. Trang, with the new regulation, people with serious illnesses that local hospitals do not have the professional qualifications to treat because the technical list has not been approved will of course be examined and treated at a higher-level hospital.

In addition, a new point of the Health Insurance Law also has a great impact on many people with chronic diseases, that is, in cases where chronic diseases are transferred from higher levels to grassroots health care for management, in some cases, patients are still given expensive drugs, as prescribed by higher levels for treatment.

Source: https://thanhnien.vn/42-benh-hiem-ngheo-se-khong-phai-xin-giay-chuyen-tuyen-185241128134245418.htm