Ensuring medical examination and treatment benefits for health insurance participants when the contribution level increases
(Baonghean.vn) - From July 1, 2023, the basic salary will increase from VND 1,490,000 to VND 1,800,000. When the basic salary increases, the health insurance premium will also increase. The increase in the premium, the legitimate demand of insurance participants is that the quality of technical services and public services also needs to increase accordingly.
Increase contribution, increase benefits
According to Resolution No. 69/2022/QH15, from July 1, 2023, the basic salary will increase from VND 1,490,000 to VND 1,800,000. When the basic salary increases, a series of policies will be affected, including the contribution level.health insurancealso increased.
Specifically, for workers, civil servants and public employees, from July 1, 2023, when the basic salary is adjusted to increase from VND 1.49 million to VND 1.8 million, the maximum health insurance contribution will increase from VND 447,000/month to VND 540,000/month. For students, from July 1, 2023, the health insurance contribution for this group will increase from VND 563,220/year to VND 680,400/year. For members of near-poor and poor households, from July 1, the contribution will increase from VND 241,380/year to VND 291,600/year.
For family health insurance, the first person in the household pays 81,000 VND/month, 972,000 VND/year (increased by 13,950 VND/month, 167,400 VND/year); the second person pays 56,700 VND/month, 680,400 VND/year (before July 1 it was 46,935 VND/month, 563,220 VND/year); the third person pays 48,600 VND/month, 583,200 VND/year (before July 1 it was 40,230 VND/month, 482,760 VND/year); The 4th person has a contribution of 40,500 VND/month, 486,000 VND/year (before July 1st it was 33,525 VND/month, 402,300 VND/year); the 5th person and beyond has a contribution of 32,400 VND/month, 388,800 VND/year (before July 1st it was 26,820 VND/month, 321,480 VND/year).
From July 1, 2023, the benefits of health insurance participants will also be increased, specifically: The new list of health insurance drugs according to Circular No. 20/2022/BYT of the Ministry of Health, effective from March 1, 2023, has added many types of drugs covered by health insurance, including 47 additional chronic drugs provided at health stations, expanding many types of drugs to upgrade hospitals, drugs for patients: mental illness, Covid-19, HIV/AIDS..., thereby increasingly better meeting the benefits of health insurance participants.
Along with that, the health insurance benefits of health insurance participants will also increase, specifically: Health insurance participants will be paid 100% of the total cost of medical examination and treatment if the cost of medical examination and treatment is lower than 15% of the basic salary at the time of going to work.medical examination and treatment(from July 1, 2023 onwards is 270,000 VND); the total payment level for medical supplies for one use of technical services does not exceed 45 months of basic salary (from July 1, 2023 onwards is 81,000,000 VND); each type of medical supplies has its own payment level according to regulations of the Ministry of Health.
For those who have participated in health insurance for 5 consecutive years or more and have the amount of co-payment for medical examination and treatment costs in the year greater than 10.8 million VND (6 months of basic salary), the amount exceeding 6 months of basic salary will be paid by the Health Insurance Fund and the patient will be paid 100% of the medical examination and treatment costs from this point until the end of the year.
Improve service quality
As the health insurance premium increases, the legitimate demand of insurance participants is to enjoy high-quality technical and public services. To meet this demand, currently, Nghe An Social Insurance and Nghe An Health sector have been strengthening coordination to improve the quality of health insurance services in a modern, professional and user-friendly manner.
To improve the rights of patients with health insurance examination and treatment, in the coming time, the Insurance - Health sector will be determined to effectively implement solutions to improve the quality of medical examination and treatment services, promote the development of science and specialized technology, bring many benefits, create maximum favorable conditions for participants and beneficiaries of health insurance policies; promote the application of information technology, digital transformation in reforming medical examination and treatment procedures, and payment of medical examination and treatment costs under health insurance.
Nghe An Social Insurance will organize the implementation of the Health Insurance policy in the area in accordance with regulations; strengthen the management of health insurance examination and treatment funding sources, prevent abuse and profiteering of health insurance examination and treatment funds and infringe upon the rights of the majority of patients undergoing health insurance examination and treatment; continue to effectively deploy the use of chip-embedded Citizen Identification Cards or health insurance card images on the VssID-BHXH application to replace paper health insurance cards in health insurance examination and treatment, helping people access medical services more quickly.
On the side of Nghe An Health sector, we will focus on directing 527 medical examination and treatment facilities to sign health insurance examination and treatment contracts (including 1 central level facility, 12 provincial level facilities, 54 district level facilities (29 non-public facilities) and 460 commune level facilities, health agencies and units to continuously improve the quality of services, medical examination and treatment techniques... to meet the requirements and create conditions for health insurance participants to enjoy high-tech services right in their locality, reduce travel costs during the examination and treatment process, contributing to reducing the burden on central level hospitals.
Along with that, the health sector also directed medical facilities (district level and above) to focus and make efforts to build "Smart Hospitals" - strongly increase the application of information technology, digital transformation to implement administrative reforms; help to eliminate medical mistakes and errors as well as administrative procedure errors; reduce waiting time and procedures for patients and their families. Patients with health insurance cards no longer have to bring many types of documents when going for medical examination and treatment...; focus on implementing the application of information technology in medical examination and treatment management and health insurance payment.
The industry has directed medical examination and treatment facilities to carefully study documents related to the health insurance regime and policies; grasp new guidance documents of all levels and sectors to implement them in a timely manner. Along with that, it is necessary to improve the quality of medical examination and treatment, ensure the rights of people who are examined and treated under health insurance when the salary regime and policies along with the health insurance contribution level increase... The industry has assigned responsibility to medical examination and treatment facilities under health insurance to manage and use the allocated funds in accordance with regulations, effectively and economically, ensuring the rights of people with health insurance cards./.
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