Question:

I registered for medical examination and treatment in this district but go to another district in the same city. Will I be covered by health insurance? - Mr. Tran The Quynh (Hanoi).

Vietnam Social Security replied:

According to the provisions of Article 22 of the Law on Health Insurance, if you initially register for health insurance in this district but go to a health facility in another district in the same city and complete all health insurance procedures (present health insurance card and photo identification), the health insurance fund will pay as follows:

In case you register for initial health insurance at a district hospital/general clinic/commune health station:

- Medical examination and treatment at district-level hospitals/general clinics/commune-level health stations will be covered by the health insurance fund at 100% of the medical examination and treatment costs within the scope of payment of the health insurance fund and the benefit level stated on the health insurance card.

- Medical examination and treatment at provincial hospitals are covered by the health insurance fund for 100% of inpatient treatment costs within the scope of payment of the health insurance fund and the benefit level stated on the health insurance card; the health insurance fund does not pay in case of outpatient medical examination and treatment.

- For medical examination and treatment at a central hospital, the health insurance fund will pay 40% of the inpatient treatment costs within the scope of payment of the health insurance fund and the benefit level stated on the health insurance card; the health insurance fund will not pay in case of outpatient medical examination and treatment.

In case you register for initial health insurance at a provincial/central hospital:

- Medical examination and treatment at a central hospital: the health insurance fund will pay 40% of the inpatient treatment costs within the scope of the health insurance fund and the benefit level stated on the health insurance card; the health insurance fund will not pay in case of outpatient medical examination and treatment.

- Medical examination and treatment at provincial hospitals: the health insurance fund will pay 100% of inpatient treatment costs within the scope of payment of the health insurance fund and the benefit level stated on the health insurance card; the health insurance fund will not pay in case of outpatient medical examination and treatment.

- Medical examination and treatment at district-level hospitals: the health insurance fund will pay 100% of medical examination and treatment costs within the scope of payment of the health insurance fund and the benefit level stated on the health insurance card.

- Go to a general clinic or commune health station for medical examination and treatment: The health insurance fund will not pay for medical examination and treatment costs.