Increased health insurance card fees: More benefits for patients.

(Baonghean) - From July 1, 2017, the family health insurance premium increased by 7.4%. Many people are worried about this information; however, the Social Insurance sector affirms that the change in the premium has been carefully calculated and will not significantly affect people's lives. In fact, the benefits for health insurance participants will be significantly increased.

Paying for medical examination and treatment at Vinh City General Hospital. Photo: Thanh Son

Increase in health insurance premiums

Mr. Vu Van Hong's family in Hamlet 6, Hung Xa Commune, Hung Nguyen District consists of 5 people. The entire family works in agriculture locally. To facilitate medical examinations and treatment, Mr. Hong's family decided to purchase family health insurance.

While waiting for his turn to be examined at Vinh City General Hospital, Mr. Hong recounted: Last August, his old health insurance card expired, so he went to the collection agency at the commune's People's Committee to buy new cards for the whole family. There, he learned that the family health insurance participation fee had increased from July 1, 2017.

He was explained that, according to the Health Insurance Law, the family health insurance contribution rate is based on the basic salary. Therefore, after July 1, 2017, the basic salary increased from 1,210,000 VND to 1,300,000 VND, which means an increase of approximately 7.4% in the family health insurance contribution rate.

Mr. Hong said that the increase in fees came as a surprise to him and many other residents, but after receiving the explanation, he found it reasonable. A careful calculation reveals that the increase is insignificant, only about 20,000 - 50,000 VND per person per year. His family has five members, excluding the 2-year-old child, so four people need to purchase health insurance. Compared to last year, this year the health insurance premium for Mr. Hong's family has only increased by 136,000 VND.

Even for poor and near-poor families, this fee increase will not have any impact. In fact, those in poor households already receive 100% of their fees subsidized by the State budget, while those near-poor receive 70% subsidy.

Furthermore, according to Decision No. 53/2016/QD-UBND of the People's Committee of Nghe An province, which stipulates the level of support for health insurance contributions for people belonging to near-poor households in Nghe An province during the 2016-2020 period, in addition to the 70% health insurance contribution supported by the Central Government, in 2016, the province also provided an additional 10% support for health insurance contributions, 15% in 2017, 20% in 2018, 25% in 2019, and 30% in 2030.

Ensuring the rights of patients.

Regarding concerns about whether the fee increase will ensure the rights of people when receiving medical examination and treatment, Dr. Nguyen Hong Truong - Director of Vinh City General Hospital, said: “The rights of patients will be thoroughly explained by medical staff and insurance officials during examination, treatment, and payment. Personally, I believe that increasing the contribution rate is reasonable, ensuring the safety of the fund and the rights of the vast majority of patients.”

According to Dr. Truong, this fee increase has a specific roadmap and plan, and has been carefully calculated, so the benefits for patients are very high. Specifically: For those with health insurance cards who receive medical examination and treatment according to regulations, if the total cost of a single examination and treatment is less than 195,000 VND, they will not have to make co-payments (the regulation before the change was less than 181,500 VND).

Illustrative image.

For cases where patients are prescribed high-tech services by medical facilities according to Decision 36/2005/QD-BYT of the Ministry of Health on the promulgation of the List of high-tech, high-cost services, the health insurance fund will reimburse within the benefit limit but not exceeding 52 million VND per service use (the old regulation was not exceeding 48.4 million VND); the health insurance fund will reimburse 100% of co-payment costs exceeding 7.8 million VND for those who have participated in health insurance for 5 consecutive years or more (the old regulation was 7.26 million VND).

In addition, the total payment for medical supplies for a single use of a technical service shall not exceed VND 58.5 million (the old regulation was VND 54.45 million); this regulation does not apply to medical supplies with a specified payment rate in column 5 of the List of Medical Supplies in Appendix 01 issued with Circular 04/2017/TT-BYT of the Ministry of Health.

Before implementing the new fee structure, the Nghe An Provincial Social Insurance agency effectively disseminated information to all segments of the population, minimizing public anxiety. Ms. Tran Thi Ha, Head of the Revenue Management Department of the Nghe An Provincial Social Insurance agency, stated: The Nghe An Provincial Social Insurance agency has been, is, and will continue to cooperate with media agencies from the provincial to the grassroots level, especially the broadcasting systems of communes, wards, and villages, to inform all citizens about the changes in health insurance policies and laws.

To date, the majority of people in the province have become aware of and supportive of the changes in health insurance contribution rates. This is reflected in the increase in the number of people in households participating in health insurance. In July 2017, there was an increase of 20,825 people in households participating in health insurance compared to June 2017; and in August 2017, there was a further increase of 8,068 participants compared to July 2017.

Currently, health insurance coverage extends to over 82% of Nghe An's population. To further expand coverage, Nghe An Social Insurance continues to implement solutions to ensure the rights of health insurance participants, including: continuing to reform administrative procedures to create the most favorable conditions for people to participate in health insurance and ensuring that health insurance cards reach buyers as quickly as possible; and strengthening communication efforts to show people that health insurance is a humane policy, benefiting not only themselves but also their family members and the community. In addition, the Social Insurance agency will strengthen its monitoring of health insurance fund expenditures at hospitals to ensure participants can see that their contributions are being spent correctly and effectively.

The provincial Social Insurance sector also hopes that medical facilities will continue to make greater efforts to improve the quality of health insurance examinations and treatments, and reform administrative procedures so that patients do not have to wait long for examinations. Only then will people clearly see the benefits and rights of participating in health insurance.

Thanh Son