Ministry of Health responds to the issue of not being covered by health insurance when examining at a polyclinic outside the province

Medical staff perform medical examination and treatment procedures under health insurance - Illustration photo: NAM TRAN

Voters in Tay Ninh province proposed at the 7th session of the 15th National Assembly that the Ministry of Health should advise on amending the Law on Health Insurance (HI) in the direction of providing a route for people participating in HI to receive medical examination and treatment at the same level nationwide (medical examination and treatment facilities from district level down).

Responding to voters on this issue, Minister of Health Dao Hong Lan said that from January 1, 2021, according to regulations in Clause 6, Article 22 of the Law on Health Insurance, health insurance participants who go to medical examination and treatment at provincial-level medical examination and treatment facilities will also be paid by the health insurance fund for inpatient treatment costs according to the scope and level of benefits.

The Minister of Health also said that the Ministry of Health has compiled and developed guidelines for the above recommendations in the draft Law amending and supplementing a number of articles of the Law on Health Insurance; it is expected to be submitted to the National Assembly for consideration and approval in the near future.

According to Tuoi Tre Online 's research, in the draft Law on Health Insurance that is being consulted, the Ministry of Health proposes to increase the payment rate for district health centers without inpatient beds, general clinics, regional general clinics with beds, medical examination and treatment facilities under the Ministry of National Defense and the Ministry of Public Security that only provide outpatient treatment, which are classified as initial level.

Specifically, the Ministry of Health proposed to increase the rate of payment for medical examination and treatment costs from 0% to 100% for those who initially registered for medical examination and treatment outside the province. Previously, only those who were examined at district hospitals nationwide and initially registered within the province were entitled to 100%. Due to the inadequacy of the current law, the nationwide connection is only applied to district hospitals and not to the above-mentioned facilities.

The Ministry of Health assessed that this regulation helps simplify administrative procedures and ensure equality between equivalent types of facilities, making it more convenient for people to go to primary health care facilities for medical examination and treatment.

Source: https://tuoitre.vn/bo-y-te-tra-loi-viec-khong-duoc-huong-bhyt-khi-kham-o-phong-kham-da-khoa-ngoai-tinh-20240816163629086.htm