There will soon be regulations to ease difficulties for health insurance patients who have to buy medicine outside.

According to the Draft, the health insurance fund will pay for medicine and medical supplies directly to patients with health insurance cards or pay for medicine and medical supplies to medical examination and treatment facilities in cases where the following three conditions are met:

Medicines and medical supplies prescribed to patients are within the scope of benefits of health insurance participants.

The patient is diagnosed, prescribed and assigned medicine and medical supplies, but at the time of use, the active ingredients of the medicine and medical supplies are not available at the medical examination and treatment facility: There is no finished medicine containing the active ingredients that the patient is prescribed; there is no suitable medical supplies that the patient is prescribed to use.

Payment of medicine and medical supplies costs directly to health insurance participants is made according to the principle that the patient or the patient's relative or legal representative as prescribed by law purchases medicine and medical supplies at the hospital pharmacy of the medical examination and treatment facility where the patient is treated.

The unit supplying medicine and medical supplies must meet the following conditions: Have won a bid with any medical examination and treatment facility that has signed a contract for medical examination and treatment covered by health insurance;

Medicines and medical supplies have been used and paid for by patients with health insurance cards at the medical examination and treatment facility where the supplier won the bid;

The patient or the patient's relative or legal representative as prescribed by law shall present to the social insurance agency the prescription and medical supplies prescribed by the medical staff at the medical examination and treatment facility and the legal and valid invoice for the purchase of drugs and medical supplies as the basis for payment.

The Social Insurance Agency that receives the application for direct payment is responsible for directly paying the cost of medicine and medical supplies for the patient according to the prescribed cases.

The cost paid directly by the health insurance agency to the patient is equal to the cost recorded on the patient's legal invoice provided by the hospital pharmacy or supplier and according to the benefit level within the scope of benefits of the health insurance participant.

The Social Insurance Agency shall deduct the health insurance costs paid to the medical examination and treatment facility where the patient is treated as follows:

In case the cost of medicine and medical supplies is calculated outside the price of technical services: The medical examination and treatment costs of the medical examination and treatment facility shall not be deducted from the health insurance fund;

In case the cost of medicine and medical supplies is calculated outside the price of technical services: Deduct the cost of medical examination and treatment covered by health insurance of the medical examination and treatment facility equal to the cost that the health insurance agency has paid directly to the patient according to the provisions of Clause 3 of this Article.

Previously, public opinion was outraged that patients with health insurance cards had to buy medicine and supplies from outside for their treatment without being paid for.

Regarding this, Ms. Tran Thi Trang, Director of the Department of Health Insurance, Ministry of Health, in principle, medical examination and treatment facilities are responsible for ensuring the availability and adequate supply of medicines, and not allowing patients to buy them outside during their inpatient treatment.

If patients are allowed to buy by themselves, there will be many risks related to drug quality, patient safety, dispute resolution when there are complications, risks, misuse of prescriptions, patients have to buy at high prices, it is difficult to determine the payment price, and medical facilities rely on not bidding.

In fact, the phenomenon of medical facilities not being able to supply medicine and medical supplies, forcing patients to buy them themselves, has been going on for a long time, with both subjective and objective reasons.

Some medical examination and treatment facilities prescribe outside purchases to avoid exceeding the total amount, exceeding the ceiling, drugs not on the list, not eligible for health insurance payment, entangled in procurement bidding, due to the impact of the epidemic, the supply of drugs and medical supplies is also affected and interrupted to some extent, drug prices increase, and there is also a fear of responsibility in procurement and bidding in some units.