The Ministry of Health has just sent a document to the Vietnam Social Security regarding the application of the basic salary level as prescribed in Decree No. 73 of the Government in the payment of medical examination and treatment costs under health insurance (HI).

According to the Ministry of Health, based on the provisions of Decree No. 73 dated June 30, 2024 of the Government stipulating the basic salary and bonus regime for cadres, civil servants, public employees and armed forces, the Ministry of Health guides the implementation of payment of health insurance medical examination and treatment costs in the transition period from July 1, 2024 to December 31, 2024 as follows:

Regarding the level of health insurance benefits as prescribed in Point d, Clause 1, Article 14 of Decree No. 146 dated October 17, 2018 of the Government detailing and guiding measures to implement a number of articles of the Law on Health Insurance from July 1, 2024 or in cases where a patient is hospitalized or starts treatment before July 1, 2024 but is discharged from the hospital or finishes treatment from July 1, 2024:

The cost of one medical examination and treatment is lower than 15% of the basic salary: Equivalent to lower than 351 thousand VND.

Regarding the direct payment level as prescribed in Article 30 of Decree No. 146 from July 1, 2024 or in case the patient is hospitalized or starts treatment before July 1, 2024 but is discharged or ends treatment from July 1, 2024:

At point a, clause 1, the maximum amount is not more than 0.15 times the basic salary: Equivalent to a maximum of not more than 351 thousand VND.

At point b, clause 1, the maximum amount is not more than 0.5 times the basic salary: Equivalent to a maximum of not more than VND 1,170,000.

In Clause 2, the maximum amount is not more than 1.0 times the basic salary: Equivalent to a maximum of not more than VND 2,340,000.

In Clause 3, the maximum amount is not more than 2.5 times the basic salary: Equivalent to a maximum of not more than VND 5,850,000.

The total payment level for medical supplies for one use of technical services shall not exceed 45 months of basic salary as prescribed in Point b, Clause 2, Article 3 of Circular No. 04 dated April 14, 2017 of the Ministry of Health promulgating the list, rates and payment conditions for medical supplies within the scope of benefits of health insurance participants:

In case of patients admitted to hospital from July 1, 2024: equivalent to not exceeding VND 105,300,000.

In case a patient is admitted to the hospital or begins treatment before July 1, 2024 but is discharged or ends treatment from July 1, 2024, the total payment for medical supplies for one use of technical services is determined according to the time of completion of the technical service and the cost is calculated at 2 times as follows:

Before July 1, 2024: Apply the basic salary level stipulated in Decree No. 24 dated May 14, 2023 of the Government stipulating the basic salary level for cadres, civil servants, public employees and armed forces, equivalent to not exceeding 81 million VND.

From July 1, 2024: Apply the basic salary stipulated in Decree No. 73 dated June 30, 2024 of the Government, equivalent to not exceeding VND 105,300,000.

According to the guidance of the Ministry of Health, from July 1, 2024 and in the case of a patient admitted to the hospital or starting treatment before July 1, 2024 but discharged from the hospital or ending treatment from July 1, 2024, the amount of co-payment for health insurance examination and treatment costs in the year is greater than 6 months of basic salary to determine the non-co-payment benefit as prescribed in Point d, Clause 1, Article 14 of Decree No. 146 is greater than the amount determined as follows:

Note, for cases where the co-payment amount from January 1, 2024 to before July 1, 2024 is sufficient or exceeds 6 months of basic salary, they will enjoy benefits according to the provisions of Point d, Clause 1, Article 14, Decree No. 146 and this formula will not apply .