Ministry of Health responds to the issue of not being covered by health insurance when examining at a polyclinic outside the province

Medical staff perform health insurance medical examination and treatment procedures - Illustration photo: NAM TRAN

Voters of Tay Ninh province proposed at the 7th session of the 15th National Assembly that the Ministry of Health should advise on amending the Law on Health Insurance (HI) in the direction of opening up the health insurance system for people participating in health insurance to receive medical examination and treatment at medical examination and treatment facilities at the same level nationwide (medical examination and treatment facilities from district level down).

Responding to voters on this issue, Minister of Health Dao Hong Lan said that from January 1, 2021, according to the provisions of Clause 6, Article 22 of the Law on Health Insurance, health insurance participants who go to medical examination and treatment at provincial-level medical examination and treatment facilities without the right line will also have the health insurance fund pay for inpatient treatment costs according to the scope and level of benefits.

The Minister of Health also said that the Ministry of Health has compiled and developed guidelines for the above-mentioned recommendations in the draft Law amending and supplementing a number of articles of the Law on Health Insurance; it is expected to be submitted to the National Assembly for consideration and approval in the near future.

According to Tuoi Tre Online 's research, in the draft Law on Health Insurance that is currently soliciting opinions, the Ministry of Health proposes to increase the payment rate for district health centers without inpatient beds, general clinics, regional general clinics with beds, medical examination and treatment facilities under the Ministry of National Defense and the Ministry of Public Security that only provide outpatient treatment, which are classified as initial level.

Specifically, the Ministry of Health proposed to increase the rate of payment for medical examination and treatment costs from 0% to 100% for those who initially registered for medical examination and treatment outside the province. Previously, only those who were examined at district hospitals nationwide and initially registered within the province were entitled to 100%. Due to the inadequacy of the current law, it only applies nationwide to district hospitals and has not yet applied to the above facilities.

The Ministry of Health assessed that this regulation helps simplify administrative procedures and ensure equality between equivalent types of facilities, making it more convenient for people to go to primary health care facilities for medical examination and treatment.

Source: https://tuoitre.vn/bo-y-te-tra-loi-viec-khong-duoc-huong-bhyt-khi-kham-o-phong-kham-da-khoa-ngoai-tinh-20240816163629086.htm