Capping hospital fees for people without health insurance cards

From June 1, people without health insurance cards will be subject to a new ceiling on hospital fees.

The Ministry of Health has just issued Circular No. 02/2017/TT-BYT regulating the maximum price range for medical examination and treatment services not covered by the Health Insurance Fund (HIF) in State medical examination and treatment facilities and providing guidance on applying prices and payment of medical examination and treatment costs in some cases.

This Circular adjusts hospital fees for those who have not participated in health insurance, or have a card but go to the hospital for examination and treatment or use services not covered by the health insurance fund (not including examination at voluntary examination departments, upon request).

This Circular applies to public medical examination and treatment facilities, patients who have not participated in health insurance, people with health insurance cards but when examining and treating patients or using medical examination and treatment services not covered by the health insurance fund.

Accordingly, the maximum price range for medical examination and treatment services includes: direct costs such as drugs, infusions, chemicals, consumables, replacement materials to perform medical examination and treatment services, costs of electricity, water, fuel, waste treatment, environmental sanitation, costs of maintenance, equipment maintenance, purchase of replacement tools and instruments, etc.; Salary costs include salary by grade, position, allowances, regular allowances, surgery and procedure allowances, etc.

From June 1, medical facilities will officially apply new medical service prices including more than 1,900 medical services, including: Maximum price range for medical examination and health check-up services; treatment bed day services; technical services, testing...

According to this price frame, the examination fee at a special-class hospital is 39,000 VND, at a second-class hospital is 35,000 VND, at a third-class hospital is 31,000 VND; at a fourth-class hospital and a commune health station: 29,000 VND. Some procedures and surgeries are also adjusted to increase in price by about 20-30% compared to the current price.

The competent authority (Ministry of Health, Provincial People's Council, etc.) shall decide on the specific price level, but it shall not exceed the maximum price level of this Circular. This price level includes direct costs (medicines, infusions, chemicals, consumables, etc.); and salary costs.

The daily bed price is calculated per person per bed, sharing a bed with two people is only charged a maximum of 50%, sharing a bed with three or more people is only charged a maximum of 30%. In case of lying on a stretcher or temporary folding bed, the daily bed price for sharing a bed with two people is applied.

The time of implementation at medical examination and treatment facilities is decided by the competent authority.

In addition, this circular also adds prices for 35 services not covered by health insurance such as: cosmetic services, denture replacement, hearing aids, strabismus, myopia and refractive error treatment... For these services, people with health insurance cards still pay the same price as people without health insurance cards because these services are not covered by the Health Insurance Fund.

According to the Ministry of Health, this adjustment of medical service prices is to create equality between people with health insurance cards and those without, in order to encourage people to participate in health insurance. Currently, according to statistics from the Vietnam Social Security, the number of people participating in health insurance reaches 82% of the population, so there are still 18% of the population that have not participated in health insurance.

According to Infonet