The Ministry of Health is drafting the Decree amending a number of articles in Decree No. 146 and Decree 75 to adjust the rights of participants in health insurance in accordance with the new provisions of the Law on Medical Examination and Treatment.
Many subjects are entitled to 100% of medical examination and treatment expenses as proposed by the Ministry of Health
Accordingly, in the draft, the Ministry of Health proposes to amend the scope and level of health insurance for participants.Specifically, the health insurance fund will pay 100% of the cost of medical examination and treatment for many groups of subjects, including people with meritorious services to the revolution, Vietnamese heroic mothers, wounded soldiers, and sick soldiers with a decline in the impaired rate.High working capacity, resistance activists infected with heavy chemicals, and children under 6 years old.
Notably, the draft expansion of the scope covers 100% of costs at grassroots health facilities, not only limited to the commune level as the current regulations.Accordingly, including communal, ward and town health stations;Restiles;health departments of agencies and units;Family medicine clinic;and some outpatient medical examination and treatment facilities in the army and police.
In addition, the draft also proposes to pay 100% of the cost for cases where the treatment cost is lower than 15% of the base salary for a medical examination and treatment.Participants in health insurance for 5 years or more and have a total cost of payment for more than 6 months of the basic salary will receive 100% of medical examination and treatment costs, regardless of treatment.
This revision proposal, if approved, will make an important contribution to improving the quality of health services, reducing the financial burden on people when medical examination and treatment.
According to Vietnam Social Insurance, in the past 15 years, the health insurance fund has paid nearly 1 million billion dong for medical examination and treatment with health insurance.In 2023, the number of medical examination and treatment with health insurance from the health insurance fund was about 123 trillion dong, 8 times higher than in 2009.Social protection group is 5 million VND/person.
Statistics by the end of 2023, the health insurance fund is more than VND 40,000 billion.In particular, in 3 years 2020-2022, due to the influence of Covid-19 epidemic, the number of visits decreased sharply and lack of drugs and materials, so the payment of reduced, the health insurance fund was over VND 33,000 billion.