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People sign up for health insurance at Thong Nhat Hospital (Tan Binh District, Ho Chi Minh City) – Photo: DUYEN PHAN
According to the new announcement from the Social Security Agency (Social Security), provincial patients who do not need a referral for hospital treatment in Ho Chi Minh City are still covered 100% by health insurance (HI).
After the Tuoi Tre report, many readers responded by wondering how correct this regulation is. How do patients who have health insurance cards elsewhere go to Ho Chi Minh City for a medical examination and treatment?
Exchange with Online youth On the morning of December 19, Ms. Nguyen Thi Thu Hang, Deputy Director of the Ho Chi Minh City Social Insurance Agency, said that the regulations apply to hospitals at the provincial / municipal level, and to hospitals central, patients are only entitled to 40% of the medical insurance. .
Specifically, patients who are hospitalized at Cho Ray Hospital, 175 Hospital, Central Dental Hospital, and Thong Nhat Hospital without a referral only receive 40% of the medical insurance.
100% paid for patients with emergency medical insurance or referral letter. Patients with health insurance cards in other provinces go to outpatient care (not hospitalized) at Ho Chi Minh City health centers without a referral letter that is not covered by health insurance, the cost will be paid by the patient .
Previously, according to the announcement of the Social Security of Vietnam, as of January 1, 2021, the health insurance agency carried out the hospitalization service at the national level. Patients in the province with health insurance do not need a referral for hospital treatment in Ho Chi Minh City are still covered 100% by health insurance.
Recently, the HCM City Social Security Agency has also issued documents to guide the medical examination and treatment facilities covered by health insurance. Consequently, the health insurance fund pays 100% of the costs of hospital treatment according to the rate prescribed for the insured when self-seeking a medical examination and treatment at the wrong level in provincial medical facilities around the country. country. .
The City of HCM Social Security Agency suggests that medical examination and treatment facilities covered by health insurance implement and strictly administer the reception and indication of hospital treatment in accordance with the insured’s medical condition, in accordance with the scope professional. and the number of approved boarding beds.
In other cases (outpatient examination and treatment) use the referral form or the follow-up appointment paper. The reexamination appointment is only valid once within 10 business days from the date of the reexamination appointment.
In cases where the medical insurance cards are valid until December 31, 2020, when the medical examination and treatment are carried out in the last days of the year, the drugs prescribed by the doctor and the course will continue to be prescribed and supplied. treatment.
