Guidance on some regulations in medical examination and treatment with health insurance

01/10/2019 06:30 PM


The Ministry of Health has just dispatched Official Letter No. 5823/ BYT-BH answering some recommendations of Vietnam Security; including clarifying and guiding many contents in the field of medical examination and treatment with health insurance.

Firstly, direct payment is executed for the loss of health insurance card.

According to the Ministry of Health, stemming from the practice, there are cases where the patient cannot present the health insurance card due to emergency, unconsciousness or death situation and the case of the patient losing the card without timely  procedures operation for re-issuance (or only discovered the card lost at the time of examination) have not been covered by health insurance benefits; Based on Point c, Clause 2, Article 31 of the Law on Health Insurance, the Minister of Health stipulates the case where the patient does not present the health insurance card before leaving the hospital or being transferred in the day due to emergency situation, loss of consciousness or death or their cards are lost, payment will be made directly to the social insurance agency.

Secondly, medical examination and treatment and payment of medical treatment costs covered by health insurance are organized through regular routes at army and police clinics

- For infirmaries under the Ministry of Public Security: The Ministry of Health has sent a dispatch to the Director of the Department of Health in coordination with a medical facility affiliated to the Ministry of Public Security in the area to develop a list of infirmaries operating as a hospital. They are allowed to conduct medical services at the district level.

- For infirmaries under the management of the Ministry of Defense: The Ministry of Health has proposed the Ministry of Defense to evaluate, review and make a list of infirmaries operating as a hospital to implement at the district level for the health insurance users when they come to get medical examination. The authorization to determine the operating model of infirmaries belongs to the Ministry of Defense.

Thirdly, initial registration for medical examination and treatment are made for foreigners in Vietnam.

According to the Ministry of Health, foreigner participants of health insurance can belong to many different target groups (pupils, students, workers, etc). At Points a and b, Clause 1, Article 9 of Circular No. 40/2015/TT-BYT, the Ministry has assigned the Department of Health to coordinate with the provincial social insurance body to guide initial cases of medical care registration for medical facilities at the district and commune levels to meet the needs of the insured and in accordance with the capacity of the medical facility.

The determination of the initial health insurance facility (at the commune, district, provincial, or central level) to meet the health care needs of the foreign health insurance card holders is determined by the Department of Health in accordance with the law regulations on medical examination and treatment.

Official Letter No. 5823/BYT-BH was issued on October 2, 2019. /.

VSS