From July 1, people with health insurance will enjoy a special benefit when going to the doctor.

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, regime and benefits of health insurance will also be adjusted in accordance with the new regulations.

Currently, if the cost for a medical examination and treatment is lower than 15% of the basic salary (lower than 223,500 VND), health insurance participants will be paid 100% of the cost.

When the basic salary increases to 1.8 million VND/month, the cost for one medical examination mentioned above will change to 270,000 VND.

Accordingly, people with health insurance cards who go to medical examination and treatment in accordance with regulations, with a total cost per 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 VND 46,500 from July 1, 2023. This is a health insurance benefit that increases when the basic salary increases.

Changes in conditions for enjoying 100% coverage of medical examination and treatment costs

In addition to policy groups, health insurance participants are only entitled to 100% of medical examination and treatment costs when they have participated in health insurance for 5 consecutive years and have the amount of co-payment for medical examination and treatment costs in the year 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 amount 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.

Since the co-payment conditions are based on the base salary, when the base 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 participating in health insurance for 5 consecutive years or more 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 part exceeding 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 1.8 million VND/month, people who have participated in health insurance for 5 consecutive years or more must have an amount of co-payment for medical examination and treatment costs in the year greater than 10,800,000 VND (6 months of basic salary) to enjoy the above benefits.

Minh Hoa (reported by VTV, Health & Life)

Source