Inpatient Treatment at Provincial Hospitals Will Be Covered 100%?

My father has a district-level health insurance card in Bac Ninh. Due to a serious illness, my family brought my father to Saint Paul Provincial Hospital in Hanoi for inpatient treatment. Should he be entitled to 100% coverage of treatment costs?

Clause 15 Article 1 of the Amended Law on Health Insurance 2014 stipulates as follows:

“Article 22. Health Insurance Coverage

...

  1. In cases where individuals holding health insurance cards seek medical examination and treatment at inappropriate levels, payment by the health insurance fund shall be determined according to the coverage provision stipulated in Clause 1 of this Article, as follows, except as specified in Clause 5 of this Article:

a) At central hospitals, 40% of the inpatient treatment costs;

b) At provincial hospitals, 60% of the inpatient treatment costs from the effective date of this Law until December 31, 2020; 100% of the inpatient treatment costs nationwide from January 1, 2021;

c) At district hospitals, 70% of the costs for medical examination and treatment from the effective date of this Law until December 31, 2015; 100% of the costs for medical examination and treatment from January 1, 2016.”

Thus, from January 1, 2021, when seeking treatment at a provincial hospital, your father will enjoy 100% coverage for inpatient treatment costs. For example, if your father is entitled to 80% health insurance coverage, when receiving inpatient treatment at Xanh Pon Hospital, 80% of this treatment cost will be covered.

Respectfully!

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