Vietnam: Benefits of health insurance participants in social distancing period

Facing the complicated situation of COVID-19 epidemic across Vietnam, on July 29, 2021, Vietnam Social Security issued Official Dispatch 2259/BHXH-CSYT instructing social insurance agencies of provinces and cities to implement some of the following contents to ensure the interests of the insured. Specifically:

Vietnam: Benefits of health insurance participants in social distancing period (Artwork)

For localities implementing social distancing according to Directive 16:

- The provincial social insurance agency shall notify and guide the insured patients to receive medical examination and treatment at the most convenient medical examination and treatment establishments in their area. Regardless of place of registration for initial medical examination and treatment, they shall enjoy the benefits of medical examination and treatment covered by health insurance as in the case of medical examination and treatment at the right level.

- Coordinate with medical examination and treatment establishments to transfer patients according to professional requirements and reception capacity at higher levels.

For example,

Mr. A participates in voluntary health insurance and registers for initial medical examination and treatment at Tan Binh district hospital (district hospital), but currently, Mr. A is living near Thong Nhat hospital (central hospital). For your convenience, to ensure compliance with the distance, Mr. A will be examined and treated at Thong Nhat hospital and will be covered by the health insurance fund as on the right line.

In addition, the provincial social insurance agencies need to coordinate with health care facilities with health insurance to ensure adequate and timely health care benefits for participants of health insurance in accordance with the provisions of the Law on Health Insurance in accordance with the actual situation of the locality and the unit; do not let the patient have to pay the cost of medical treatment within the scope of benefits and the level of health insurance benefits as prescribed during the medical examination and treatment at the medical facility:

- Patients with health insurance can take diagnostic tests for COVID-19 according to the guidance of the Ministry of Health and are paid by the health insurance fund or the state budget according to regulations;

- For patients with chronic diseases such as hypertension, diabetes, and cancer being managed and treated at central and provincial hospitals: Based on the list of patients updated and notified by the Center for Health Insurance Assessment and Multi-line Payment, on the Assessment Information System, the provincial social insurance agency shall coordinate with the Department of Health and medical facilities in organizing the management of medical examinations and provision of drugs at qualified lower-level establishments.

Note: Regulations on medical examination and treatment, regardless of places of initial medical examination and treatment as mentioned above, only apply to localities that are socially distant according to Directive 16. When the social distance is over, it will no longer apply.

Bao Ngoc

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