Vietnam Social Security answers questions about payment of medical examination and treatment costs

The Social Insurance Agency will provide 80% of the excess health insurance medical examination and treatment costs to local Social Insurance agencies to pay for medical examination and treatment facilities. The remaining amount will be paid by the Social Insurance Agency when approved by the competent authority for additional...

The information was stated by Vietnam Social Security in a document responding to voters' petitions sent before the 7th Session of the 15th National Assembly regarding the payment of health insurance medical examination and treatment costs.

Vietnam Social Security said it received a petition from voters of Thanh Hoa province sent by the National Assembly's Petition Committee before the 7th Session of the 15th National Assembly with the following content: Ngoc Lac Regional General Hospital requests Vietnam Social Security to consider paying for the cost source exceeding the total amount that has been appraised, agreed upon, and recorded over the years according to the provisions of Decree No. 75/2023/NDCP dated October 19, 2023 of the Government.

Regarding the content of the voters' petition, Vietnam Social Security informed that according to the report of Thanh Hoa Provincial Social Security, the amount exceeding the total payment according to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding measures to implement a number of articles of the Law on Health Insurance, paid according to Decree No. 75/2023/ND-CP dated October 19, 2023 of the Government, in Thanh Hoa province is more than 315.36 billion VND.

Of which, Ngoc Lac Regional General Hospital, Thanh Hoa province, is nearly 14.3 billion VND (in 2019, it was more than 6.28 billion VND and in 2020, it was more than 8 billion VND). This entire cost is included in the excess of the health insurance medical examination and treatment expenditure estimate assigned by the Prime Minister for 2019 and 2020 to Thanh Hoa province.

Vietnam Social Security has compiled the costs exceeding the above total payment level, submitted them to the Social Security Management Board, and approved them in Resolution No. 1726/NQHĐQL dated June 10, 2024 to report to the Prime Minister for consideration and approval.

At the same time, allow 80% of the cost of health insurance examination and treatment exceeding the budget to be allocated to the Social Insurance of the provinces, to pay for health insurance examination and treatment facilities.

Implementing Resolution No. 1726/NQ-HDQL, at the end of June 2024, Vietnam Social Security issued Official Dispatch No. 2106 to notify and provide 80% of the health insurance medical examination and treatment costs exceeding the above estimate.

Including costs exceeding the total payment in 2019 and 2020 of Ngoc Lac Regional General Hospital (Thanh Hoa province). The remaining amount will be paid by the Social Insurance agency to the medical examination and treatment facility after the Prime Minister approves the supplement.

According to statistics from the Vietnam Social Security, by the end of 2023, 93.6 million people had participated in health insurance, reaching a coverage rate of 93.35% of the population. In 2023, the whole country had over 174 million health insurance examinations and treatments by over 39 million people using health insurance cards.

Also in 2023, the amount of health insurance medical examination and treatment expenses from the Health Insurance Fund will be about 123 trillion VND.

The 2014 revised Law on Health Insurance increased health insurance coverage for poor households from 95% to 100%; for near-poor households from 80% to 95%. Social protection groups also have their medical examination and treatment costs covered by the fund at 100%.

Source: https://baolaocai.vn/bao-hiem-xa-hoi-viet-nam-tra-loi-thac-mac-ve-viec-thanh-toan-chi-phi-kham-chua-benh-post387345.html