(Dan Tri) - From July 1, when the revised Law on Health Insurance (HI) takes effect, it will adjust the conditions for patients to have 100% of their medical examination and treatment costs covered by the HI fund.
From the beginning of the year to before July 1
In 2025, the regulations on health insurance will be applied in two different phases. The phase before July 1 will apply according to the current Law on Health Insurance; that is, the Law on Health Insurance 2008, amended in 2014 and supplemented by a number of other laws.
The level of health insurance benefits for health insurance participants is stipulated in Article 22 and is guided in detail in Article 14 of Decree 146/2018/ND-CP, then amended in Clause 5, Article 1 of Decree No. 75/2023/ND-CP.
Accordingly, people in the following 8 groups participating in health insurance paid by the state budget will be paid 100% of medical examination and treatment costs when going for medical examination and treatment according to regulations.
The following 8 groups participating in health insurance paid by the state budget will have 100% of medical examination and treatment costs paid (Graphic: Tung Nguyen).
In addition, Article 14 of Decree 146/2018/ND-CP also stipulates 7 groups of people entitled to 100% of medical examination and treatment costs and does not apply a limit on the rate of payment for drugs, chemicals, medical supplies and technical services.
7 groups of people are entitled to 100% of medical examination and treatment costs and there is no limit on payment rate (Graphic: Tung Nguyen).
In addition to the 15 groups that are entitled to 100% of medical examination and treatment costs in all cases as above, Article 14 of Decree No. 146/2018/ND-CP also stipulates 3 cases in which all groups participating in health insurance are entitled to 100% of medical examination and treatment costs.
3 cases in which groups participating in health insurance are entitled to 100% of medical examination and treatment costs (Graphic: Tung Nguyen).
From 1/7 onwards
From July 1, the 2024 Health Insurance Law officially takes effect, so the health insurance regulations will be applied according to this law. The 2024 Health Insurance Law completely amends Article 22, which regulates the health insurance benefits of health insurance participants.
Accordingly, the 2024 Law on Health Insurance stipulates that 11 groups participating in health insurance paid by the state budget will enjoy 100% of medical examination and treatment costs when examining and treating patients in accordance with regulations.
11 groups participating in health insurance paid by the state budget will enjoy 100% of medical examination and treatment costs (Graphic: Tung Nguyen).
Article 22 of the 2024 Law on Health Insurance also stipulates 3 cases in which health insurance participants are entitled to 100% coverage of medical examination and treatment costs.
3 cases in which groups participating in health insurance are entitled to 100% of medical examination and treatment costs (Graphic: Tung Nguyen).
The latest point of the 2024 Health Insurance Law is that patients will be paid 100% by health insurance according to the benefit level specified on their health insurance card in cases of medical examination and treatment not at the original registered facility, not in accordance with regulations on patient transfer...
Source: https://dantri.com.vn/an-sinh/dieu-kien-huong-100-chi-phi-kham-chua-benh-bhyt-nam-2025-20250101015217348.htm
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