Expanding medical examination and treatment benefits and health insurance payments

This information was given at the Conference on implementing the revised Law on Health Insurance organized by the Ministry of Health on March 27, 2025. According to the representative of the Department of Health Insurance (Ministry of Health), the health insurance fund is currently maintaining a stable reserve fund with a surplus of VND 40,000 billion, helping to ensure the sustainability of the health insurance system.

Deputy Minister of Health Tran Van Thuan spoke at the meeting.

One of the important changes of the revised Law on Health Insurance is the expansion of benefits for health insurance participants, especially medical examination and treatment regardless of administrative boundaries.

Patients will be covered 100% of their medical expenses at primary health facilities nationwide. They will also be covered 100% of their inpatient medical expenses at any primary health facility previously designated as a district-level facility.

In particular, patients will have the right to be transferred to specialized medical facilities if necessary, especially in cases of treatment of rare or serious diseases.

In addition, the amended Law also provides clearer regulations on payment of drug costs, medical equipment, and paraclinical service costs transferred between medical examination and treatment facilities in case of drug or equipment shortages. This helps improve the ability to meet people's treatment needs and minimize the shortage of medical resources.

In particular, measures to handle cases of late payment of health insurance or evasion of payment of insurance have also been regulated more strictly, creating fairness in insurance participation.

Another notable point is the new regulation on the level of health insurance support for students. The Ministry of Health said it will increase the support level from 30% to 50% for high school students from grades 1 to 12.

The above regulation not only helps reduce the financial burden for families with children participating in health insurance but also creates more favorable conditions for students to participate in insurance.

For the student group, the current health insurance support level remains at 30%, although the number of students participating in insurance tends to grow strongly.

Deputy Minister of Health Tran Van Thuan said that along with improvements in payment levels, the revised Law on Health Insurance also adjusts the method of payment for medical examination and treatment costs.

Health insurance will pay for medical services such as telemedicine, telemedicine support, family medicine, rehabilitation, regular pregnancy check-ups, and childbirth. In particular, medical technical services, drugs, equipment, blood, and blood products will also be paid if they are within the scope of benefits of the insured person.

One of the important goals of the revised Law on Health Insurance is to enhance transparency in insurance settlement, while reducing administrative procedures and promoting digital transformation in health insurance management and payment. This will help save time for people and minimize the risk of errors in the process of settling insurance benefits.

With these amendments, the Law on Health Insurance will make a big step forward in improving people's rights when participating in health insurance. The new regulations not only reduce difficulties in accessing health services, but also create motivation for people to participate in health insurance, contributing to improving public health and ensuring fairness in the health system.

Source: https://baodautu.vn/mo-rong-quyen-loi-kham-chua-benh-va-chi-tra-bao-hiem-y-te-d259550.html