The healthcare system is continually expanded. Currently, the country has nearly 13,000 HI healthcare facilities (including approximately 2,897 healthcare facilities and nearly 10,000 commune health centers). The HI examination and treatment system is organized from the central to the local levels, including both public and non-public facilities, which help people easily access and use HI healthcare services.

VSS General Director Nguyễn Thế Mạnh, visits and gives presents to health insurance patients who paying high medical cost

The number of people has medical examination and treatment increases each year. Over the past 15 years, there have been over 2.12 billion visits for HI medical examination and treatment. In 2023, there were over 174 million HI medical examination and treatment visits (nearly double compared to 2009) by over 39 million health insurance card users.

Primary healthcare (including district and commune levels) accounts for 95% of HI medical examination and treatment facilities. From 2018 to 2023, primary healthcare accounted for nearly 75% of the total HI medical examination and treatment visits, with expenditures at this level accounting for about 34% of total HI expenditures. This expresses the crucial role of primary healthcare in providing medical services to HI participants at commune health facilities, contributing to the effectiveness of healthcare service.

In the past 15 years, the HI fund has paid nearly 1 quintillion VND for HI medical examination and treatment. In 2023, HI medical examination and treatment expenditures from the HI fund amounted to approximately 123 trillion VND, eight times the amount in 2009. The HI fund has truly become an important financial resource, contributing to the healthcare of the population.

Moreover, the coverage and range of medications, medical supplies, and technical services paid for by the HI fund have been continually expanded to meet the needs of HI patients. Many expensive medications, including targeted therapies for cancer treatment, have been added to the HI reimbursement list. Expensive replacement materials, such as artificial hip joints and arterial stents, have been covered by the HI fund, amounting to thousands of billions of VND annually. Regarding reimbursement rates, the amended 2014 HI Law increased HI coverage from 95% to 100% for households classified as poor, from 80% to 95% for near-poor households, and also covered 100% of medical costs for social protection groups. In 2023, the average HI medical examination and treatment expenditure for retirees was 6.3 million VND per person, and for social protection groups, it was 5 million VND per person, with the average HI contribution for these groups being 1.3 million VND per year.

The quality of health insurance examination and treatment is increasingly improving (Illustrative photo)

Specifically, regulations on health insurance referral have greatly facilitated participants. Since 2016, HI members can visit any district-level hospital for medical examination and treatment, and since 2021, they can receive inpatient treatment at any provincial-level hospital nationwide with entitlements equivalent to their designated level of care.

It can be said that the HI fund has played a significant role in sharing burdens between the healthy and the ill, the young and the elderly, and those with high and low incomes. In recent years, in addition to covering regular medical expenses, the HI fund has also disbursed billions of VND annually for cases involving severely ill patients, rare diseases, and more. A recent example is the case of Nguyen Quoc Trinh, a 19-year-old from Thanh Hoa province suffering from the rare and serious condition Pemphigus Vulgaris. After a 7-month treatment journey at Bach Mai Hospital, the HI fund covered nearly 800 million VND, allowing him to return to a normal life./.