Many cases have had billions of dong in medical examination and treatment costs paid by the Health Insurance Fund.

Recently, many people with health insurance cards who have serious illnesses have had their health insurance fund pay hundreds of millions to billions of dong for health insurance examination and treatment. Thanks to the health insurance card, patients have more motivation and confidence to continue treatment.

The Law on Health Insurance stipulates that all people have the right to participate in health insurance and have the same scope of health insurance benefits for each group of subjects; health insurance participants are paid by the health insurance fund an unlimited amount of medical examination and treatment costs according to the scope and level of benefits, which can be up to billions of VND/year. Notably, participants are fully paid by the health insurance fund for health insurance medical examination and treatment costs according to regulations, without being limited by disease type, age, number of treatment days, or total health insurance medical examination and treatment costs.

A doctor examines and treats a patient. Photo: VNA.

Along with that, the benefits of health insurance participants are increasingly expanded in both scope and level of benefits. The quality of health insurance treatment is concerned and improved, people have access to many modern and highly effective medical services.

Currently, the list of drugs covered by the health insurance fund basically meets the medical needs of patients with more than 1,000 active ingredients, modern biological products and hundreds of oriental medicines, medicines from medicinal herbs. Among them, there are many drugs to treat rare diseases, cancer, hemophilia, cardiovascular diseases... These are groups of diseases that require long-term or lifelong treatment, have high treatment costs, patients with health insurance cards are prescribed long-term use and have lifelong medications for the treatment process.

In addition to drug costs, health insurance participants are also covered by the health insurance fund for technical services and medical supplies. These include high-cost surgeries and procedures such as robotic surgery, joint replacement surgery, spinal disc replacement, pacemaker placement, etc. Notably, some types of medical supplies covered by the health insurance fund are worth hundreds of millions of dong.

According to statistics from Vietnam Social Security from 2024 to the end of May 2025, some cases of patients with health insurance cards will have large costs paid by the health insurance fund, specifically as follows:

1. The patient who received the highest payment from the health insurance fund was more than 4,888 billion VND with the main diagnosis of "Glycogen storage disease": health insurance card code TE13535212XXXXX, born in 2019, old Ha Nam province.

2. The patient with the second highest payment from the Health Insurance Fund is more than 4,304 billion VND with the main diagnosis of "Anemia", glycogen accumulation and pneumonia: card code TE10101318XXXXX, born in 2021, Hanoi City.

3. The patient with the third highest payment from the health insurance fund is more than 4,287 billion VND with the main diagnosis of glycogen accumulation: card code TE13036226XXXXX, born in 2019, old Hai Duong province.

4. The patient with the 4th highest payment from the health insurance fund is more than 4,221 billion VND with the main diagnosis of glycogen accumulation, hypertrophic cardiomyopathy: card code TE13636227XXXXX, born in 2020, old Nam Dinh province.

5. The patient with the 5th highest payment from the health insurance fund is more than 4,093 billion VND with the main diagnosis of glycogen accumulation: card code TE12626216XXXXX, born in 2021, old Vinh Phuc province.

6. The patient with the 6th highest payment from the Health Insurance Fund is more than 3,886 billion VND with the main diagnosis of metabolic disorder: card code TE17979397XXXXX, born in 2020, Ho Chi Minh City.

7. The patient with the 7th highest payment from the Health Insurance Fund is more than 3,374 billion VND with the main diagnosis of glycogen accumulation: card code TE10101319XXXXX, born in 2021, Hanoi City.

8. The patient with the 8th highest payment from the health insurance fund is more than 3,361 billion VND with the main diagnosis of glycogen accumulation: card code TE12626216XXXXX, born in 2022, old Vinh Phuc province.

9. The patient with the 9th highest payment from the health insurance fund is more than 3,168 billion VND with the main diagnosis of glycogen accumulation, heart failure: card code TE14545209XXXXX, born in 2022, Quang Tri province.

10. The patient with the 10th highest health insurance payment is more than 3,034 billion VND with the main diagnosis of congestive heart failure: card code BT27979310XXXXX, born in 1941, Ho Chi Minh City.

In fact, there have been many cases where health insurance participants have used high-tech, high-cost medical services, with the health insurance fund paying up to billions of VND. In recent years, on average, the health insurance fund has paid health insurance medical expenses of more than VND 100 trillion each year for nearly 150 million people. In 2024 alone, the health insurance fund paid health insurance medical expenses of a total of VND 142,985 billion for 183.6 million people.

In particular, in the context of increasing medical costs, timely payment in accordance with the regulations of the Health Insurance Fund has become more important than ever. Thanks to that, people have significantly reduced medical expenses, especially for many people with serious and chronic diseases... with long-term medical examination and treatment with high costs, when the Health Insurance Fund pays for medical examination and treatment costs, they have more motivation to overcome the difficulties of illness. The Health Insurance Fund not only contributes to timely financial support for patients, but also creates conditions for medical examination and treatment facilities to operate stably, and has conditions to improve service quality.

It can be seen that the health insurance policy has practical significance, contributing significantly to the health care work of our Party and State for the people. Participating in health insurance is not only the right of every citizen but also demonstrates the responsibility to comply with the law and the spirit of mutual love and sharing with those who are unfortunate to have health risks.

According to VNA

Source: https://doanhnghiepvn.vn/tin-tuc/nhieu-truong-hop-duoc-quy-bhyt-chi-tra-hang-ty-dong-chi-phi-kham-chua-benh/20250709082959093