Latest points on health insurance medical examination and treatment from 2025

According to regulations of the Ministry of Health , from 2025, the list of health insurance drugs will not be divided by hospital class.

According to regulations of the Ministry of Health, from 2025, the list of health insurance drugs will not be divided according to hospital class.

Currently, the list of drugs covered by health insurance is classified by hospital class and specialized level. However, from January 1, 2025, this regulation will be abolished according to Circular No. 37 issued by the Ministry of Health.

According to regulations of the Ministry of Health, from 2025, the list of health insurance drugs will not be divided according to hospital class.

According to Ms. Vu Nu Anh, Deputy Director of the Department of Health Insurance (Ministry of Health), Circular 37 abolishes the classification of hospitals in the list of health insurance drugs, and also removes the note on the regulations on the rate and conditions of payment for drugs used for some facilities.

The new regulation allows medical examination and treatment facilities to use the entire list of health insurance drugs, in accordance with the scope of professional activities and diagnostic and treatment guidelines, regardless of hospital class or technical level.

This regulation is expected to help encourage medical facilities to develop expertise, attract human resources, and enhance health care capacity at lower levels.

At the same time, this regulation limits the situation of patients flocking to higher levels, reducing overload for central hospitals.

In addition to abolishing drug classification, Circular 37 also adds new regulations on drug payment. Medical examination and treatment facilities are paid for drug costs by the Health Insurance Fund in accordance with the scope of professional activities, capacity to perform technical services, equipment conditions and human resources.

The Circular also regulates cases of payment for drugs that are not indicated or contraindicated in professional documents, but are used in emergency situations or when there is no alternative drug after consultation. Flexible regulations in special situations such as natural disasters, catastrophes or wars are also added.

According to the regulations in Circular 39, which has just been issued, the Ministry of Health emphasizes the principle of "correct, sufficient and reasonable" in the use of drugs. Specifically, this Circular adds many new types of drugs to the list covered by health insurance, including drugs for the treatment of rare diseases and chronic diseases. This helps patients reduce the burden of treatment costs.

The drugs in the list are classified and adjusted to prioritize modern treatment regimens, suitable for clinical practice and treatment needs in Vietnam.

Specific regulations on drug bidding processes aim to reduce drug shortages and ensure reasonable drug prices, helping people access high-quality drugs at low costs.

Supplementing special drugs for children, the elderly and patients with rare diseases. At the same time, price support policies for vulnerable patient groups are also applied.

The health insurance payment process has been improved to reduce application processing time, helping health insurance participants receive benefits more quickly.

According to a representative of the Ministry of Health, the new regulations in Circular 37 and Circular 39 are expected to improve the rights of health insurance participants, ensure more effective access to medicine, and contribute to improving the quality of medical examination and treatment services at all health care levels.

Source: https://baodautu.vn/nhung-diem-moi-nhat-ve-kham-chua-benh-bao-hiem-y-te-tu-nam-2025-d230867.html