Ensuring medical examination and treatment under health insurance when implementing two-level local government

Vietnam Social Security has issued an official dispatch on ensuring medical examination and treatment under health insurance when implementing the two-level local government model.

Accordingly, to ensure the legitimate rights of health insurance participants and the continuous and smooth medical examination and treatment of health insurance before, during and after administrative units are organized into two levels (provincial and communal levels), this agency requests that the Social Insurance of the regions implement the following contents.

Firstly, proactively coordinate with the Department of Health and health insurance medical examination and treatment facilities to ensure full benefits for health insurance patients. Notify health insurance medical examination and treatment facilities to coordinate to continue using health insurance cards issued to health insurance participants for medical examination and treatment under the health insurance regime when the address information and place of initial medical examination and treatment registration on the health insurance card have not been adjusted for health insurance medical examination and treatment facilities that are rearranged and reorganized at administrative units at all levels.

Second, the Department of Health is requested to ensure legal conditions within its authority for the social insurance agency to coordinate with reorganized medical examination and treatment facilities (dissolved, merged, newly established) to promptly sign contracts or appendices to health insurance medical examination and treatment contracts; ensure that health insurance medical examination and treatment contracts are implemented continuously and fully.

In case the medical examination and treatment facility is reorganized into a new commune health station that is eligible to sign a health insurance medical examination and treatment contract, the district-level social insurance agency shall directly sign the contract, ensuring continuity and inheritance of the terms and conditions of the contract signed with the medical examination and treatment facility managing the commune health station.

Third, urgently coordinate with health insurance examination and treatment facilities to finalize data, organize appraisal and payment, and settle health insurance examination and treatment costs for the second quarter of 2025 and make advances for health insurance examination and treatment costs for the third quarter of 2025 according to regulations.

Fourth, assign officers and civil servants of the Health Insurance Regime Department to coordinate with health insurance examination and treatment facilities subject to arrangement to promptly resolve and ensure the rights of health insurance participants when going for medical examination and treatment in the most convenient way.

According to Vietnam Social Security, by the end of the second quarter of 2025, the whole country had about 96.46 million people participating in health insurance, reaching a coverage rate of 95.2% of the population; an increase of 4.333 million people over the same period last year.

The number of health insurance examinations and treatments has also increased recently. It is estimated that in the first 6 months of the year, there were nearly 95.6 million people undergoing health insurance examinations and treatments, an increase of 8.44%. The cost of health insurance examinations and treatments was VND 76.1 trillion, an increase of nearly VND 10 trillion (14.8%) compared to the same period in 2024.

Brother Chi

Source: https://nhandan.vn/bao-dam-kham-chua-benh-bao-hiem-y-te-khi-thuc-hien-chinh-quyen-dia-phuong-2-cap-post890788.html