How will health insurance benefits change when Ho Chi Minh City merges?

When Ho Chi Minh City merges with Binh Duong and Ba Ria - Vung Tau, will people's health insurance benefits change? Tuoi Tre had an interview with Ms. Nguyen Thi Thu Hang, Deputy Director of Social Insurance Region 27, about the related changes.

Patients receive medical examination at Thu Duc Regional General Hospital - Photo: DUYEN PHAN

Ms. Nguyen Thi Thu Hang said that in the near future, Ho Chi Minh City will merge with Binh Duong and Ba Ria - Vung Tau , and the social insurance agencies of these provinces and cities will also merge.

Specifically, from June 1, 2025, Ho Chi Minh City, Binh Duong and Ba Ria - Vung Tau Social Insurance have officially merged into Social Insurance Region XXVII (27), with headquarters located at 5 Nguyen Dong Chi, Tan Phu Ward, District 7, Ho Chi Minh City.

In addition, Social Insurance Region 27 also has 36 district-level Social Insurance offices that continue to perform the tasks and powers of Social Insurance in the management area until the competent authority rearranges them to suit the commune-level administrative unit. The list of 36 district-level Social Insurance offices under Social Insurance Region 27 after the merger is specified in Notice 3537/TB-BHXH dated May 30, 2025 of Ho Chi Minh City Social Insurance.

* What should people pay attention to when contacting the Social Security agency?

- Despite the change in organizational structure, people do not need to travel far to carry out administrative procedures related to social insurance. District-level social insurance agencies still maintain operations and receive people's records according to their current management areas.

* When merging like that, will people's health insurance cards change compared to before?

- The merger of administrative units does not affect people's health insurance benefits. Health insurance facilities still operate normally and people still enjoy health insurance benefits when receiving medical examination and treatment at these facilities. To ensure their rights, people should integrate their health insurance cards into the VssID or VNeID application and contact the local social insurance agency for support when necessary.

* The district level will be abolished in the near future, many people want to know how district hospitals will operate? In particular, what will be the benefits of people with district-level health insurance? Will their rights to medical examination and treatment with health insurance be guaranteed?

- The reorganization of district-level administrative units does not change the health insurance benefits of health insurance cardholders. District hospitals can change their names to be more suitable and operate normally, continuing to receive, treat and pay health insurance as they do now. Health insurance cardholders who register at the district level will still enjoy full benefits according to regulations.

People do not need to change their health insurance cards, do not need to worry about transferring to another facility or losing benefits. People with health insurance cards, when going to primary health care (health care facilities without beds), basic hospitals (before January 1, 2025, district hospitals) or specialized hospitals (before January 1, 2025, district hospitals), or going to specialized hospitals for treatment that belong to 62 groups of diseases specified in Appendix 1 issued with Circular No. 01/2025/TT-BYT dated January 1, 2025 of the Ministry of Health "Detailed regulations and instructions for the implementation of a number of articles of the Law on Health Insurance"; when presenting health insurance card information and personal identification documents, they will receive 100% of the benefit level.

Health insurance participants are guaranteed benefits by the State regardless of changes in administrative organization.

* What are the procedures for people in Binh Duong and Ba Ria - Vung Tau who need to transfer their health insurance to hospitals in Ho Chi Minh City?

- According to the amended Law on Health Insurance (effective from January 1, 2025), people have the right to change their initial medical examination and treatment facility within the first 15 days of each quarter (January, April, July, October). Required documents: citizen identification card/card, health insurance card (paper or on VssID), form TK1-TS (declaration form for changing medical examination and treatment facility).

* For many years, people from the provinces have wanted to go to hospitals in Ho Chi Minh City because they think that hospitals in Ho Chi Minh City have many good doctors and modern equipment. After the merger, if many people from the provinces choose hospitals in Ho Chi Minh City as their initial place for medical examination and treatment, will it lead to overload at the hospitals?

- Allowing flexibility in choosing the initial health insurance treatment location is a good trend, suitable for people's needs. However, to avoid overloading upper-level hospitals as well as hospitals in Ho Chi Minh City, the health sector needs to step up upgrading, medical equipment and training human resources, and providing professional support to lower-level hospitals.

People should also consider their actual needs. For common diseases, mild diseases or diseases that have been treated stably by higher-level facilities and transferred to lower-level facilities for monitoring and treatment, they should choose lower-level medical examination and treatment facilities near their place of residence for convenient monitoring and to reduce travel costs. They should not choose hospitals that are too large just because of the mentality of "more people is better", to avoid wasting time and service quality.

* How do people in Binh Duong and Ba Ria - Vung Tau benefit from health insurance when they go to hospitals in Ho Chi Minh City for medical examination and treatment?

- According to the provisions of Law No. 51/2024/QH15, the Law amending and supplementing a number of articles of the Law on Health Insurance, from January 1, 2025, administrative boundaries by province in health insurance examination and treatment will be abolished. Therefore, people with health insurance cards when going to primary or basic health examination and treatment facilities (before January 1, 2025, district-level hospitals) or specialized hospitals (before January 1, 2025, district-level hospitals) will enjoy health insurance according to regulations.

Therefore, people with health insurance cards living in Binh Duong, Ba Ria - Vung Tau or other provinces when going to the above medical facilities in Ho Chi Minh City for examination and treatment, when presenting health insurance card information and personal identification documents, will receive 100% of the benefit level.

THUY DUONG

Source: https://tuoitre.vn/quyen-loi-bao-hiem-y-te-thay-doi-the-nao-khi-tp-hcm-sap-nhap-20250629224147675.htm