Actively participate in health insurance to enjoy many benefits in medical examination and treatment.

In fact, in recent years, when participating in health insurance, people enjoy many benefits when going to medical examination and treatment. By the end of June 2023, the whole province had over 916,000 people participating in health insurance, the coverage rate reached 92.3% of the population. Thus, there are currently about 8% of the population who do not have a health insurance card. One of the reasons is that there are still some people who do not clearly understand the benefits, importance, and meaning of the health insurance card or think that they are still young and healthy and do not need it, so they do not participate.

Mr. Tran Van Vinh, Gia Lac commune (Gia Vien district) felt regretful when he had to pay nearly 40 million VND due to a traffic accident when he did not have a health insurance card. Meanwhile, someone in the same room had a more serious accident than him but the payment amount was only a few million VND because the health insurance had paid most of the hospital fees. Mr. Vinh felt regretful because he had been repeatedly propagandized and mobilized by the social insurance and health insurance collection agents of the commune, but he subjectively thought that he was young, healthy, and would not get sick, but he did not know when the unfortunate accident would happen.

"During my hospital stay, I also witnessed many seriously ill people, who expected their treatment costs to be quite high, but they were not too worried because they knew that health insurance would cover 85-90% of the total costs. Learning from my own experience, I discussed with my wife that no matter what, we had to join health insurance. Right after being discharged from the hospital, my wife and I would save up more than 1 million VND to buy health insurance for both of us. I found that, even though we are young and healthy, life is unpredictable, so having a "lucky charm" to take care of your health is still more reassuring.

According to Dr. Nguyen Van Tuyen, Deputy Director of the Provincial General Hospital, the hospital treats about 1,000 inpatients every day, of which over 90% use health insurance cards. For many types of diseases, especially serious and incurable diseases that require regular and long-term treatment, such as cardiovascular diseases, cancer, artificial kidneys, accidents... each treatment costs tens to hundreds of millions of VND. Without a health insurance card, patients will have difficulty maintaining treatment, which is very disadvantageous for themselves and their families.

In order to improve the quality of examination, treatment and health care for patients, in recent times, the Provincial General Hospital has focused on improving the medical examination and treatment process, increasing investment in facilities, equipment, human resources; improving medical ethics and codes of conduct for medical staff, doctors, etc., creating convenience for the people, without distinction between health insurance medical examination and treatment services on demand.

In particular, the Provincial General Hospital always focuses on applying new and modern clinical and paraclinical techniques; deploying advanced medical services; applying IT in management, connection, and communication of health insurance medical examination and treatment data, meeting well the payment of medical examination and treatment costs, ensuring the rights of patients.

In recent times, to help people quickly access and enjoy the practical benefits of the health insurance policy, and at the same time implement the roadmap towards universal health insurance according to Resolution No. 21 of the Politburo, the Social Insurance and Health sectors have actively coordinated with agencies, units, sectors, unions, and local authorities to strengthen communication and mobilization so that people clearly understand their rights and obligations, thereby actively participating in health insurance.

Propaganda work is increasingly widespread and widespread, helping each citizen to proactively learn about the rights, obligations, and regulations of the law on health insurance, thereby actively participating in health insurance, effectively using the health insurance card when going to medical examination and treatment to protect the health of themselves, their families, and share with the community.

Actively participate in health insurance to enjoy many benefits in medical examination and treatment. — Treatment for a serious case at Ninh Binh Provincial General Hospital.

Comrade Dinh Nho Khanh, Deputy Director of Ninh Binh Provincial Social Insurance, said: From July 1, 2023, the basic salary will be adjusted to 1.8 million VND/month according to Decree 24/2023/ND-CP of the Government. Therefore, the contribution level and regime, and benefits of health insurance (HI) will also be adjusted in accordance with the new regulations.

Currently, the cost of a medical examination and treatment (KCB) is lower than 15% of the basic salary (lower than 223,500 VND), then the health insurance participant is paid 100% of the cost. When the basic salary increases to 1.8 million VND/month, the cost for a medical examination as mentioned above will change to 270,000 VND. Accordingly, people with a health insurance card who go to medical examination and treatment in accordance with regulations and have a total cost of one medical examination and treatment lower than 270,000 VND (equivalent to 15% of the basic salary) do not have to make co-payment. Thus, the one-time medical examination and treatment cost covered 100% by health insurance will increase by 46,500 VND from July 1, 2023. This is a health insurance benefit that increases when the basic salary increases.

Along with that is the change in conditions for receiving 100% of medical examination and treatment costs. Accordingly, in addition to policy groups, health insurance participants are only entitled to 100% of medical examination and treatment costs when they have 5 consecutive years of health insurance participation and the amount of co-payment for medical examination and treatment costs in the year is greater than 6 months of basic salary. That is, during the year, if the medical examination and treatment cost that the patient co-pays is greater than 6 months of basic salary, the excess of 6 months of basic salary will be paid by the health insurance fund and the patient will be paid 100% of the medical examination and treatment costs from this point until the end of the year.

Because the co-payment conditions are based on the basic salary, when the basic salary changes from July 1, the conditions for exemption from co-payment will also change. Specifically, from the beginning of 2023 until June 30, people who have participated in health insurance for 5 consecutive years or more and have the amount of co-payment for medical examination and treatment costs in the year greater than VND 8,940,000 (6 months of basic salary of VND 1,490,000/month), the excess of 6 months of basic salary will be paid by the health insurance fund and the patient will be paid 100% of the medical examination and treatment costs from this time until the end of the year. From July 1, 2023, when the basic salary increases to VND 1.8 million/month, people who have participated in health insurance for 5 consecutive years or more must have the amount of co-payment for medical examination and treatment costs in the year greater than VND 10,800,000 (6 months of basic salary) to enjoy the above benefits.

July 1st of each year is the anniversary of Vietnam Health Insurance. This year, Vietnam Health Insurance Day has the theme: "Strictly implementing the Health Insurance Law towards the goal of universal health coverage and health insurance". In order to increase the number of people participating in health insurance, moving towards universal health insurance, the Department of Health and the Social Insurance sector have issued a document requesting departments, branches, sectors and localities in the province to coordinate in implementing communication and propaganda work on health insurance policies and laws; encouraging and mobilizing people to participate in health insurance associated with the goal of implementing universal health insurance, ensuring that all people are managed and cared for, are guaranteed equality in rights and obligations in participating in health insurance and enjoying health services; at the same time, raising awareness and responsibility of those working in health insurance and officials and employees in the health sector.

Currently, the rate of Ninh Binh province's people participating in health insurance is over 916,000 people, reaching a coverage rate of 92.3% of the population. To attract the remaining nearly 8% of the population to participate in health insurance, along with raising awareness, the role and responsibility of Party committees and authorities at all levels in strictly implementing policies, laws, programs and plans on health insurance, it is necessary to pay attention to and focus on propaganda and mobilization work, creating favorable conditions for groups of households, employees and employers to participate in health insurance.

The Social Insurance sector continues to promote administrative reform, enhance the application of IT, and digital transformation to improve the efficiency of serving participants. At the same time, coordinate with the Health sector and related units to improve the quality of medical examination and treatment, ensure full and timely medical examination and treatment benefits for health insurance participants, help people understand clearly and feel secure, actively participate in health insurance in a proactive and sustainable manner.

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