On December 31, 2020 the Minister of Health of Vietnam issued the Circular No. 30/2020/TT-BYT elaborating the Decree No. 146/2018/NĐ-CP guiding the Law on Health Insurance. According to this Circular, there are 08 cases of medical examination and treatment under health insurance in appropriate level in Vietnam from March 01, 2021.
Article table of contents
Specifically, according to Article 6 of the Circular No. 30/2020/TT-BYT of the Ministry of Health of Vietnam, cases of receiving medical examination and treatment under health insurance include:
1. Health insurance participants apply for medical examination and treatment in initial medical examination and treatment establishments specified on their health insurance cards.
2. Health insurance participants who apply for initial medical examination and treatment in medical examination and treatment establishments of communes or general clinics or district hospitals may receive medical examination and treatment covered by health insurance in other medical stations of communes or general clinics or district hospitals in the same provinces.
Children who have not obtained health insurance cards since birth declaration procedures have not been adopted may use birth certificates to receive medical examination and treatment in medical examination and treatment establishments mentioned above.
3. Health insurance participants who are in state of emergency are provided with emergency medical aid in any medical examination and treatment establishment in the country.
Doctors or physicians shall assess and identify state of emergency of the patients, specify in patients’ medical records and be responsible for their decisions.
4. Health insurance beneficiaries who benefit from transfer of administrative levels for receiving medical examination and treatment under health insurance as per the law, including:
- May transfer according to Article 10 and Article 11 of Circular No. 40/2015/TT-BYT on registration for initial medical examination and treatment under health insurance and transfer of administrative level for receiving medical examination and treatment under health insurance. Applications for transfer consist of transfer documents using Form No. 6 attached to Decree No. 146/2018/ND-CP and other documents (if any);
- May transfer according to Clause 3 Article 14 of Decree No. 146/2018/ND-CP, including: emergency medical aid; cases where beneficiaries are diagnosed with other diseases exceeding the specialty of medical examination and treatment establishments during inpatient treatment process; disease development exceeds capacity of medical examination and treatment establishments during inpatient or outpatient treatment process;
- May transfer according to Clause 2 Article 6 of Circular No. 04/2016/TT-BYT on elaborating to medical examination, treatment and payment for medical examination, treatment covered by health insurance relating to examination and treatment of tuberculosis.
5. Health insurance participants who obtain documents proving their stay in other administrative divisions when they go on working trips, participate in concentrated education in training programs, semi-boarding programs and apply for initial medical examination, treatment in medical examination and treatment establishments of the same or equivalent administrative level as their initial medical examination and treatment establishments specified on health insurance cards according to Clause 7 Article 15 of Decree No. 146/2018/ND-CP. Medical examination and treatment establishments are responsible for storing photocopy of documents specified under this Point in medical records of beneficiaries.
6. Holders of notice of re-examination appointment in case they have been transferred according to Clause 5 Article 15 of Decree No. 146/2018/ND-CP.
7. Individuals who have donated their organs and require immediate treatment after donating organs.
8. Newborn babies who must receive treatment upon birth.
Besides, cases of receiving medical examination and treatment under health insurance are also specified in Article 11 of the Circular No. 40/2015/TT-BYT. In comparison, the Circular No. 30/2020/TT-BYT of the Ministry of Health of Vietnam has supplemented the following cases:
- Health insurance participants apply for medical examination and treatment in initial medical examination and treatment establishments specified on their health insurance cards.
- Health insurance beneficiaries who benefit from transfer of administrative levels for receiving medical examination and treatment under health insurance according to Clause 3 Article 14 of Decree No. 146/2018/ND-CP and Clause 2 Article 6 of Circular No. 04/2016/TT-BYT;
- Holders of notice of re-examination appointment in case they have been transferred according to Clause 5 Article 15 of Decree No. 146/2018/ND-CP.
- Individuals who have donated their organs and require immediate treatment after donating organs.
- Newborn babies who must receive treatment upon birth.
Thus, from March 2021, there are 08 cases of medical examination and treatment under health insurance in appropriate level in accordance with the Circular No. 30/2020/TT-BYT of the Ministry of Health of Vietnam. People using health insurance should pay attention to ensure maximum benefits when participating in health insurance.
Thuy Tram
- Key word:
- Circular No. 30/2020/TT-BYT
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