Estimated expenditure on medical examination and treatment covered by health insurance in 63 provinces and cities in Vietnam in 2023

Estimated expenditure on medical examination and treatment covered by health insurance in 63 provinces and cities in Vietnam in 2023

The estimate of medical examination and treatment expenditures covered by health insurance in 63 provinces and cities, for example, is as follows:

- The estimated expenditure on medical examination and treatment with health insurance in 2023 of Hanoi is VND 20,101,151 million;

- The estimated expenditure on medical examination and treatment covered by health insurance in Ho Chi Minh City in 2023 is 21,097,524 million VND;

- The estimated expenditure on medical examination and treatment covered by health insurance in Binh Duong in 2023 is VND 1,860,434 million;

- The estimated expenditure on medical examination and treatment with health insurance in Long An in 2023 is VND 689,885 million;

- The estimated expenditure on medical examination and treatment with health insurance in Can Tho in 2023 is VND 2,252,078 million;...

In addition, Decision 877/QD-TTg dated July 20, 2023 also stipulates the responsibilities of the General Director of Vietnam Social Insurance in organizing the implementation of the cost estimate for medical examination and treatment covered by health insurance as follows:

- Direct the Vietnam Social Insurance to appraise the settlement of medical examination and treatment expenditures covered by health insurance in 2023 in accordance with the Law on Health Insurance and submit it to the Social Insurance Management Council for approval, in which the report :

+ The amount of medical examination and treatment expenses covered by health insurance exceeds the estimate assigned by the Prime Minister but is within the scope of health insurance revenues for medical examination and treatment covered by health insurance and prevention in 2023;

+ The amount of medical examination and treatment expenses covered by health insurance exceeds the health insurance revenue for medical examination and treatment covered by health insurance and for prevention in 2023. On that basis, Vietnam Social Insurance:

++ Supplementing for Social Insurance of provinces and units, the amount of medical examination and treatment expenditures covered by health insurance exceeds the estimate assigned by the Prime Minister but within the scope of health insurance revenues for medical examination and treatment, health insurance and preventive care in 2023;

++ Summarize and submit to the Social Insurance Management Council for approval; send to the Ministry of Finance to submit to the Prime Minister for decision to supplement provinces and units with the amount of medical examination and treatment expenditures covered by health insurance exceeding the revenue from health insurance for medical examination and treatment, health insurance and prevention in 2023 according to the provisions of Clause 4, Article 35 of the Law on Health Insurance, which has been amended and supplemented, from the reserve fund left over from previous years (if any);

++ In case the reserve fund is not enough to supplement medical examination and treatment expenses covered by health insurance as prescribed, it is recommended to comply with the provisions of Clause 3, Article 35 of Decree 146/2018/NĐ-CP;

- Guide documents, procedures, organize the implementation of the health insurance regime to ensure that it is fast, simple, and convenient for the participants;

- Direct and guide the social insurance of provinces and centrally-run cities to advance, pay, and settle medical examination and treatment expenses covered by health insurance in accordance with the provisions of the Law on Health Insurance and Decree 146/2018/NĐ-CP.

More details can be found in Decision 877/QD-TTg, which takes effect as of July 20, 2023, and applies to fiscal year 2023.

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