Decree No 75’s new points increase benefits for health insurance participants
17/11/2023 03:37 PM
Decree No 75/2023/ND-CP has many new points that increase benefits for health insurance participants but also poses important responsibilities and high requirements for relevant agencies in implementing health insurance policies.
Le Van Phuc, director of the Department of Health Insurance Implementation under Việt Nam Social Security, said at a conference held by the Ministry of Health on November 16 that the decree adds two groups of people who are supported by the State budget to pay health insurance premiums.
The first group is the people of ATK communes and revolutionary ATK areas during the resistance war against the French and the Americans, he said.
ATK is the name of the area – including the three provinces of Thai Nguyen, Tuyen Quang and Bac Kan – that late President Ho Chi Minh selected as a safety zone to build a revolutionary base during the Anti-French resistance war (1946-54).
Delegates at the conference
The second group, who is supported with at least 70 per cent of the health insurance premium for a period of 36 months from November 1, 2023, following the Prime Minister’s decision, is ethnic groups living in communes, which recently escaped from difficult and especially difficult areas, in mountainous areas and areas home to ethnic people in the 2021-25 period, he said.
The conference, chaired by Deputy Minister of Health Tran Van Thuan, was organised to implement Decree No 75 as well as amending a number of articles of Decree No 146 of the Government, guiding measures to carry out a number of articles of the Law on Health Insurance.
According to Phuc, that Decree No 75 supplemented the group of ethnic groups living in communes, which recently escaped from difficult and especially difficult conditions, in mountainous areas and areas home to ethnic groups in the period of 2021-2025, to the group supported by the State budget to pay health insurance premiums, had an extremely important meaning to create favourable conditions for all people, especially disadvantaged groups, to have the opportunity to participate in and receive benefits from the health insurance policies, thereby contributing to maintaining and developing health insurance coverage.
The regulation that the State budget will continue to support the group of ethnic people for a period of time after they escape from poverty, so that they can accumulate and be economically eligible to participate in health insurance, demonstrates the Government's policy of ensuring social security and escaping poverty sustainably, he said.
Decree No 75/2023/ND-CP has many new points that increase benefits for health insurance participants
Decree No 75 has supplemented and increased the health insurance benefits from 80 to 100 per cent for people who have meritorious services to the revolution.
The decree also amends and supplements the rights and responsibilities of relevant parties in implementing the health insurance policies.
The decree also abolishes regulations on the total payment of medical examination and treatment costs covered by health insurance; the payment will be made based on the service prices applicable from January 1, 2019.
At the same time, it is stipulated that, on the basis of the estimates assigned by the Prime Minister, Việt Nam Social Security assigns estimates of medical and health insurance expenditures to social security offices in provinces and cities, social security offices of the Ministry of National DefenCe and the Ministry of Public Security (within the scope of 90 per cent of national health insurance revenue estimates).
After that, the social security offices will notify the expected amount of medical examination and treatment expenditure, covered by health insurance, to medical facilities. Then the medical facilities make a plan to use the amount in the year.
According to the new regulations, medical examination and treatment costs, covered by health insurance, within the scope of benefits of health insurance participants, assessed by the social security agency, will belong to the payment scope of the health insurance fund.
The payment mechanism is based on the technical services, drugs, medical supplies for patients according to current regulations.
These regulations create conditions for medical facilities to improve the quality and efficiency of their operations, ensure the rights of health insurance participants, and manage and use the health insurance fund safely.
It is expected that by the end of this year, the health insurance coverage rate will reach 93.35 per cent of the population, exceeding the plan set by the Government
The decree, which is set to take effect from December 2, 2023, has expanded conditions to access and benefit from the health insurance policies for many groups.
Notably, health insurance participants can choose to present their health insurance cards or chip-based citizen identification cards when they go for medical examination and treatment.
At the conference, most delegates made proposals to supplement and complete the implementation of the decree, such as expanding the benefits of the health insurance policies for some groups, removing obstacles in the payment of medical treatment costs, strengthening management measures, and the use of the health insurance fund.
Việt Nam Social Security has promptly issued documents guiding its social security offices in provinces and cities to proactively implement solutions, including coordination with relevant agencies to consult the Provincial People's Committee to allocate budget to support health insurance premiums for targeted groups under the decree; review, issue, and change health insurance cards of the beneficiaries under the decree.
The move aims to effectively implement the decree.
Statistics from Việt Nam Social Security showed that by the end of September this year, the country had about 91.7 million people participating in health insurance, an increase of more than 600,000 people compared to last year.
It is expected that by the end of this year, the health insurance coverage rate will reach 93.35 per cent of the population, exceeding the plan set by the Government./.
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