A Solid Foundation for Participants

The success of implementing the Health Insurance Policy in recent years has affirmed the role of this policy in social life and the lives of the people. Alongside the continuous development and improvement of the Health Insurance Policy, the participation rate of the population in health insurance has gradually increased over the years.

Effective Coordination between VSS and the Ministry of Health

Until now, health insurance coverage has reached about 93.35% of the population, equivalent to over 93.3 million participants, gradually realizing the goal of universal health coverage. Concurrently, ensuring the rights to medical treatment for those with health insurance cards has achieved significant progress. Every year, over 100 million health insurance cardholders have their rights ensured. The Health Insurance Fund has contributed effectively to replacing the outdated financial mechanism in healthcare. The Health Insurance Policy has ensured the principle of risk-sharing among participants.

In 2023, the entire country has more than 174.8 million health insurance claims, an increase of over 23.4 million compared to 2022, with the total expenditure for health insurance claims reaching about 124.3 trillion VND. Participating in health insurance is considered a form of savings – contributing when healthy to reserve for times of illness – aimed at reducing the economic burden when individuals face illnesses, including severe and costly diseases. By participating in health insurance, all citizens have access to basic healthcare services without being dependent on their ability to pay.

Statistics from the VSS show that the Health Insurance Fund annually disburses from 100,000 to 105,000 billion VND for health insurance claims. In many cases, patients receive reimbursements of several billion VND per year. In addition to covering regular medical expenses, the Health Insurance Fund also pays for many people with severe and chronic illnesses such as hemophilia (a hereditary blood clotting disorder), cancer, heart disease, and kidney failure. Therefore, for many years now, the health insurance card has been regarded by the majority of the population as a 'lifebuoy,' an indispensable 'life card' for each person.

Citizens access to many modern healthcare services and new medications

Nguyen The Manh, VSS’ Director Genera, visits patients and inspects the implementation of Health Insurance Policy at various hospitals nationwide

Accordingly, the drug list covered by the Health Insurance Fund meets the medical treatment needs of individuals with health insurance cards, encompassing over 1,000 active pharmaceutical ingredients, biological products, and hundreds of traditional medicine and herbal remedies. This includes numerous medications for cancer treatment, rare diseases, blood clotting disorders, diverse heart medications, and more. Patients are prescribed long-term use, and some medications are required for a lifetime throughout the treatment process.

Regarding the inpatient bed-day treatment costs, the Health Insurance Fund will make payments based on the hospital class and type of bed used. The average cost per inpatient bed-day treatment that the Health Insurance Fund is currently paying for is about 6 days, with the average bed cost per inpatient treatment session ranging from 1.2 to 1.5 million VND.

For special care cases, the Health Insurance Fund will cover expenses up to tens of millions of VND per treatment session, and in some cases, bed costs can be reimbursed up to hundreds of millions of VND.

Promoting ICT Application in Health Insurance Policies

To efficiently implement the health insurance examination and treatment work using the chip-embedded Citizen Identity Card, the VSS and relevant ministries and sectors have urgently deployed numerous tasks and solutions. As of now, 100% of health facilities covered by the Health Insurance Policy nationwide (equivalent to 12,851 facilities) have implemented health insurance examination and treatment using citizen identity card with a chip (meeting the requirement to look up health insurance card information by personal identification number/ citizen identity card). There have been over 55 million successful inquiries for health insurance card information using personal identification numbers/ citizen identity card to facilitate health insurance procedures.

The VSS sector continuously advances in line with trends, efficiently applying information technology to better serve beneficiaries

The simplification of administrative procedures, transparent information disclosure, and the creation of favorable conditions for individuals seeking health insurance services, simultaneously aiding in effective fund management, have been proposed by the VSS to the government. Additionally, there is active coordination with the Ministry of Public Security to implement biometric authentication technology in health insurance services. Currently, a pilot program is underway at several health facilities nationwide where beneficiaries can undergo health insurance procedures using fingerprint scanning and biometric verification on chip-embedded Citizen Identity Cards.

Presently, all administrative procedures of the VSS sector are conducted in the digital space. This brings about convenience and time and cost savings for individuals and organizations participating in and benefiting from health insurance. Digital implementation also assists businesses and laborers in easily tracking the progress of document processing, verifying data submission, issuing health insurance cards, and settling policy-related matters, enhancing the transparency of information. These benefits indicate that the digital transformation efforts of the VSS sector are heading in the right direction, yielding positive results and contributing to better service for beneficiaries, ensuring improved social security.

Health Insurance alleviates the burden for the poor

The Health Insurance Policy demonstrates profound humanitarian significance and a strong community-sharing element. Benefits of health insurance participation include free health insurance cards for children under 6 years old, financial support from the state for specific groups (such as those belonging to poor households, near-poor households, participating as a family, ethnic minorities, students, etc.), and the ability to choose a health facility near their residence for initial registration and the flexibility to change the location of initial registration.

Despite numerous efforts, the development of health insurance participation still faces challenges, such as the unsustainable participation rate and some individuals not actively engaging due to economic difficulties or a lack of awareness about the importance of health insurance. To overcome these challenges and ensure the sustainability of coverage rates, comprehensive and proactive solutions are needed. This is not only the specific responsibility of the VSS sector but also a community-wide responsibility to make health insurance truly a golden card protecting individual and family health./.