From today, January 1, 2025, cases of 62 rare and serious diseases, including cancer, will be taken directly to specialized medical examination and treatment facilities and enjoy 100% of health insurance benefits according to current regulations.
Today, January 1, 2025, Deputy Minister of Health Tran Van Thuan signed and issued Circular 01/2025/TT-BYT, providing detailed instructions on the implementation of a number of articles of the Law on Health Insurance.
This Circular takes effect from the date of signing, updating many issues in the medical field, especially on treatment and insurance for cancer patients, helping to optimize benefits for health insurance participants, and ensuring medical costs for cancer patients and patients with high costs.
Health insurance fund pays 100% of benefits for cancer patients
According to Circular 01/2025, there are 62 diseases, including rare diseases, serious diseases, diseases requiring surgery or high technology, which are covered by 100% of the benefits when examining and treating health insurance (according to the provisions of Point a, Clause 4, Article 22 of the Law on Health Insurance), and are examined and treated at specialized medical examination and treatment facilities. Health insurance participants with this disease do not have to comply with the regulations on transferring medical examination and treatment facilities (requesting a referral for treatment).
Among the 62 diseases listed above, there are cases of cancer, including: malignant tumors of the pancreas, malignant tumors of the thymus, malignant tumors of the heart, mediastinum and pleura, malignant tumors of bones and articular cartilage at other and unspecified locations, malignant tumors of the meninges, malignant tumors of the brain, malignant tumors of the spinal cord, cranial nerves and other parts of the central nervous system, secondary malignant tumors of the brain and meninges, malignant tumors of the lymphatic system, hematopoietic system and related tissues.
According to the Department of Health Insurance (Ministry of Health), for malignant tumors (from C00 - C97 according to disease codes, including cancers) in children, they are examined and treated at specialized medical examination and treatment facilities, enjoying 100% of benefits.
Patients go straight to specialized medical facilities when local medical facilities are not qualified for treatment.
Circular 01/2025 stipulates that the Department of Health Insurance (Ministry of Health) directs, guides, and organizes the implementation of this Circular. Health departments are responsible for publishing the list of primary health insurance medical examination and treatment facilities in their localities, and providing guidance on transferring patients between medical examination and treatment facilities for patients participating in health insurance.
Circular 01/2025 also stipulates the organizational form of medical agencies, units, and subordinate organizations providing initial medical examination and treatment; transferring patients between medical examination and treatment facilities; procedures for re-examination appointments according to professional requirements in medical examination and treatment...
Source: https://thanhnien.vn/nhieu-benh-nhan-ung-thu-duoc-chuyen-thang-len-tuyen-tren-tu-hom-nay-185250101153741838.htm
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