Regulations on primary health insurance medical examination and treatment facilities in Vietnam from January 1, 2025

Regulations on primary health insurance medical examination and treatment facilities in Vietnam from January 1, 2025​ (Image from the internet)

On January 01, 2025, the Minister of Health of Vietnam issued Circular 01/2025/TT-BYT, which provides detailed regulations and guidance on implementing certain provisions of the Health Insurance Law 2008.

Regulations on primary health insurance medical examination and treatment facilities in Vietnam from January 1, 2025

According to Article 6 of Circular 01/2025/TT-BYT, regulations for initial health insurance medical facilities in Vietnam are as follows:

- Initial medical examination and treatment facilities covered by health insurance, which can register initial health insurance medical examinations and treatment for participants according to Clause 1, Article 7 of Circular 01/2025/TT-BYT, include:

+ Health Stations;

+ Healthcare institutions licensed for operation under one of the forms stipulated in points a, c, e, g, and h, Clause 1, Article 6 of Circular 01/2025/TT-BYT;

+ General Clinics;

+ Regional General Clinics;

+ District Health Centers licensed for operation in the form of clinics as stipulated in point c or h, Clause 1, Article 6 of Circular 01/2025/TT-BYT;

+ Family Medicine Clinics licensed for operation under the form of general clinics;

+ Medical doctor or general practitioner clinics in communities with specially difficult socio-economic conditions;

+ Other medical facilities with internal medicine expertise and at least one of the specialties: surgery, pediatrics, obstetrics; not belonging to the forms of organization such as specialized clinics, multi-specialty clinics, dental and maxillofacial clinics, nutrition clinics, maternity homes, traditional medicine diagnostic rooms, traditional medicine clinics, laboratory facilities, imaging diagnostics facilities, dental rehabilitation, rehabilitation facilities, dialysis centers, clinical psychology facilities, nursing services, maternity care facilities, palliative care facilities, external emergency facilities, and optical facilities performing refraction error checks.

- Basic level medical facilities under health insurance are allowed to register initial health insurance medical examinations and treatment for certain participants according to Clause 2, Article 7 of Circular 01/2025/TT-BYT, including:

+ Licensed medical facilities in the form of general hospitals;

+ Medical facilities licensed under one of the following forms: specialized hospitals, traditional medicine hospitals, or dental and maxillofacial hospitals. The organizational structure of these facilities must have a professional department in the form of a department or center or institute. This department must have internal medicine expertise and at least one of the specialties: surgery, pediatrics, or obstetrics.

- Specialized healthcare facilities under health insurance are entitled to register initial health insurance medical examinations and treatment for certain participants according to Clause 3, Article 7 of Circular 01/2025/TT-BYT, including:

+ Medical facilities stipulated in point a and point b, Clause 2, Article 6 of Circular 01/2025/TT-BYT which, prior to January 01, 2025, have been designated by competent authorities as district or provincial levels or equivalent to district or provincial levels;

+ Medical facilities with functions to protect the health of officials, facilities for leprosy, tuberculosis and lung diseases, psychological, geriatric, traditional medicine within the organizational structure must have a professional department in the form of a department or center or institute. This department must have internal medicine expertise and at least one of the specialties: surgery, pediatrics, or obstetrics;

+ Other medical facilities by decision of the Ministry of Health, where the organizational structure must have a professional department in the form of a department or center or institute. This department must have internal medicine expertise and at least one of the specialties: surgery, pediatrics, or obstetrics.

Circular 01/2025/TT-BYT is effective from January 01, 2025.

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