New health insurance policy for people from provinces going to Hanoi and Ho Chi Minh City for medical treatment

From January 1, 2021, the provincial inter-provincial policy in inpatient treatment for health insurance examination and treatment will officially take effect according to the provisions of Article 22 of the Law amending and supplementing a number of articles of the Law on Health Insurance.

Accordingly, people with health insurance cards who receive medical examination and treatment at any provincial-level medical facility nationwide will have their inpatient treatment costs covered by health insurance according to the scope of benefits and levels of enjoyment.

Previously, when the provincial health insurance was not yet established, patients who went to the wrong hospital were only paid 60% of their inpatient treatment costs by the health insurance. However, from January 1, the payment rate will be 100% for the parts covered by the health insurance.

From January 1, people with health insurance cards can receive medical examination and treatment through provincial hospitals nationwide.

Inpatient treatment at the central level without a referral letter will still only be covered at 40%, except in emergency cases, patients who are ethnic minorities and poor households or people living in island communes and island districts.

The new policy will facilitate people, but many hospitals in big cities like Hanoi and Ho Chi Minh City are at risk of facing overload.

Not only that, when the provincial health insurance system is opened, medical costs will also increase, creating great pressure on the health insurance fund. It is expected that the health insurance reserve fund will only be able to cover payments until 2021.

Currently, Vietnam Social Security is coordinating with the Ministry of Health to develop guidelines for medical facilities to ensure both quality of treatment and avoid overload. Provincial inpatient admissions must be appropriate to the patient's condition, and the number of hospital beds for each medical facility must be appropriate to the human resources, equipment, and facilities, avoiding overcrowding.

The Ministry of Health also requires provincial hospitals to have a plan to inspect and rectify the organization of medical examinations, develop and implement correct medical examination and treatment procedures, and closely monitor inpatient treatment orders. In particular, it is necessary to have a coordination plan and proactively coordinate with other medical examination and treatment facilities, including district-level facilities, to transfer patients when overloaded.