Unified Payment for Health Insurance Medical Examination and Treatment

16:36, 11/07/2024

June 6, 2016, Social Insurance issued Official Dispatch 2046/BHXH-CSYT guiding the implementation of Decree No. 47/2016/ND-CP on the application of the statutory pay rate in the payment of medical examination and treatment costs under health insurance (BHYT).

Decree 47/2016/ND-CP stipulates the statutory pay rate for officials and public employees and armed forces to be applied from May 1, 2016, at VND 1,210,000 per month. However, some inconsistencies and unclear points have been encountered in paying health insurance costs for medical examination and treatment (HI). To ensure the benefits of HI patients and uniform implementation in HI policies for medical examination and treatment, Vietnam Social Security guides the following regulations effective from May 1, 2016:

- HI cardholders who undergo medical examination and treatment according to the regulations, with the total cost for one-time medical examination and treatment being less than VND 181,500, equivalent to 15% of the statutory pay rate, are not required to co-pay;- The maximum payment level for one-time usage of high-cost services for certain subjects as per regulations is VND 48,400,000, equivalent to 40 months of minimum salary;- The co-payment level for medical examination and treatment costs in a year that exceeds 6 months of the statutory pay rate is VND 7,260,000.

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