Regarding the rights of patients when receiving medical examination and treatment under health insurance, according to the Ministry of Health , the list of technical services covered by the health insurance fund currently meets the basic treatment needs of the people. Most medical examination and treatment services currently being implemented at medical facilities are within the scope of health insurance coverage. These lists are revised, supplemented, and updated to ensure the rights of patients with health insurance cards, in line with the fund's ability to pay.
Regarding health insurance benefits, the Health Insurance Law specifies the level of benefits for each category, and this level of benefit does not depend on the patient's health condition.
Currently, the list of drugs covered by health insurance basically meets the treatment needs of patients.
For certain serious illnesses, if the patient has a health insurance card and is poor or from an ethnic minority living in an area with difficult socio -economic conditions, the health insurance fund will cover 100% of the medical examination and treatment costs within the scope of their entitlement and benefit level.
The most recently issued list of modern medicines covered by health insurance (Circular No. 20/2022/TT-BYT of the Ministry of Health , stipulating the rates and conditions for payment) includes 1,037 active ingredients, chemical drugs, and biological products, divided into 27 major groups; and 59 radioactive drugs and markers. In addition, the list of traditional medicines, herbal medicines, and traditional medicinal ingredients covered by health insurance includes 229 traditional medicines and herbal medicines divided into 11 groups of effects; and 349 traditional medicinal ingredients divided into 30 groups of effects according to traditional medicine principles.
Regarding the issue of mandatory health insurance contributions for students at their schools being higher than those under the household health insurance scheme, the Ministry of Health stated that, according to the Health Insurance Law, students currently do not fall under the category of those eligible for household health insurance. The Ministry of Health will report to the competent authorities during the drafting of amendments to the Health Insurance Law to consider and adjust the regulations to better reflect reality, ensure benefits, and reduce costs for families.
Previously, some localities had requested that "the Ministry of Health research and consider advising the Government to reduce the health insurance premium for students paying at school to the same level as the health insurance premium for the third and fourth person in a household, in order to ensure fairness for health insurance participants."
Source: https://thanhnien.vn/chi-tra-bhyt-muc-huong-khong-phu-thuoc-vao-tinh-trang-benh-185240813204225802.htm
