Health insurance benefits increase with new salary

Health insurance payment area of ​​Thanh Nhan Hospital (Hanoi) - Illustration photo: NAM TRAN

The Ministry of Health has just sent an official dispatch to the Vietnam Social Security regarding the application of the new basic salary level in the payment of health insurance examination and treatment costs during the transition period from July 1 to December 31, 2024.

Accordingly, regarding the level of health insurance benefits, in case a patient is hospitalized or begins treatment before July 1 but is discharged from the hospital or ends treatment from July 1, and goes for medical examination and treatment in accordance with the provisions of the Law on Health Insurance, the cost for one medical examination and treatment is less than VND 351,000 (15% lower than the basic salary).

Compared to previous payment increased by 81,000 VND.

Regarding direct payment, in case a patient is admitted to the hospital or starts treatment before July 1 but is discharged or finishes treatment from July 1, the following regulations are specifically provided:

- In case of outpatient examination and treatment, payment is made according to regulations but not exceeding 0.15 times the basic salary, equivalent to a maximum of not exceeding 351,000 VND (previously 270,000 VND).

- In case of inpatient examination and treatment, payment is made according to regulations but not exceeding 0.5 times the basic salary at the time of discharge, equivalent to a maximum of not exceeding VND 1,170,000 (previously VND 900,000).

- In case of inpatient examination and treatment at provincial level facilities and equivalent without health insurance examination and treatment contract (except in emergency cases), payment is made according to regulations but not more than 1 time the basic salary at the time of discharge, equivalent to a maximum of 2.34 million VND (previously 1.8 million VND).

STT	Case	How to calculate ( Payment according to actual costs within the scope of benefits)	Amount paid directly from 1-7-2024
1	Outpatient	Maximum not more than 0.15 times the basic salary.	Not more than 351,000 VND (previously 270,000 VND)
2	Boarding	Maximum not more than 0.5 times the basic salary	Not more than 1,170,000 VND (previously 900,000 VND)
3	Inpatient examination and treatment at provincial hospitals and equivalent without health insurance examination and treatment contract	Maximum not more than 1.0 times the basic salary	Not more than 2.34 million VND (previously 1.8 million VND)
4	Inpatient examination and treatment at central hospitals and equivalent without health insurance examination and treatment contract	Maximum not more than 2.5 times the basic salary	Not more than 5.85 million VND (previously 4.5 million VND)

- In case a patient comes to a central-level facility for inpatient examination and treatment and does not have a health insurance contract (except in emergency cases), payment will be made according to the prescribed costs but not exceeding 2.5 times the basic salary at the time of discharge, equivalent to a maximum of 5.85 million VND (previously 4.5 million VND).

In addition, the total payment for medical supplies for one use of technical services shall not exceed 45 months of basic salary. Specifically:

In case the patient is hospitalized from July 1, the equivalent does not exceed 105.3 million VND (previously 81 million VND).

In case a patient is admitted to the hospital or begins treatment before July 1 but is discharged or ends treatment from July 1, the total payment for medical supplies for one use of technical services is determined by the time the technical service ends and the cost is calculated at 2 points in time.

Specifically, before July 1, the payment level does not exceed VND 81 million, and from July 1, the payment level does not exceed VND 105.3 million.

Source: https://tuoitre.vn/muc-huong-bao-hiem-y-te-tang-theo-luong-moi-20240703124928616.htm