Sending opinions to the 9th Session of the 15th National Assembly, voters of Dong Nai and Ninh Binh requested the Ministry of Health and relevant ministries and branches to continue to review, research, and expand the list of medical examination and treatment services covered by 100% health insurance, and consider increasing the insurance payment level for other medical examination services. At the same time, review, update, adjust, and expand the list of medical treatment drugs covered by health insurance to ensure the rights of the people.
The list of drugs is relatively complete, comprehensive and extensive compared to the health insurance premium.
Responding to the petitions of voters in these two provinces, Minister of Health Dao Hong Lan said that the list of technical services paid for by the health insurance fund for health insurance participants is relatively complete, meeting the basic treatment needs of the people with more than 9,000 technical services.
Most technical services are being implemented at medical examination and treatment facilities within the scope of payment of the Health Insurance Fund.
According to the provisions of the Law on Health Insurance, the subjects can have the Health Insurance Fund pay 80%, 95% or 100% of the cost of medical examination and treatment covered by health insurance. The adjustment of the scope of benefits and the level of enjoyment of health insurance participants is based on the contribution level and the payment capacity of the Health Insurance Fund.
According to Minister Dao Hong Lan, Vietnam is considered one of the few countries with a relatively complete, comprehensive and expanded drug list compared to the health insurance premium.
Regarding the list of modern medicines, Circular No. 20/2022/TT-BYT dated December 31, 2022 of the Ministry of Health promulgates the list and rates, payment conditions for pharmaceutical drugs, biological products, radioactive drugs and markers within the scope of benefits for health insurance participants, including 1,037 active ingredients/pharmaceutical drugs and biological products divided into 27 large groups and 59 radioactive drugs and markers; including 76 active ingredients/pharmaceutical drugs, biological products belonging to the group of drugs for cancer treatment and immunomodulation.
In addition, the list of health insurance drugs in Vietnam is listed as the name of the active ingredient/ingredient, without the content, dosage form, or trade name. Therefore, the choice of finished drugs paid for by the Health Insurance Fund at medical examination and treatment facilities is not limited by treatment indications, treatment specialties, or acute or chronic diseases.
Minister Dao Hong Lan affirmed that in reality, the number of commercial drugs covered by the health insurance fund will be much larger than the above list.
Regarding the list of traditional medicines, herbal medicines, and traditional medicinal ingredients, the consolidated document No. 13/VBHN-BYT dated October 15, 2021 of the Ministry of Health (Circular promulgating the List of oriental medicines, herbal medicines, and traditional medicinal ingredients covered by the health insurance fund) includes 229 oriental medicines and herbal medicines divided into 11 groups of effects, and 349 traditional medicinal ingredients divided into 30 groups of effects according to traditional medical theory.
These drug lists are also not classified by hospital level, so all medical examination and treatment facilities at the grassroots level, including district hospitals, can use the entire list (except for a few drugs with payment conditions at Traditional Medicine Hospitals or hospitals of level II or higher).
Urgently review, revise and supplement the list of new drugs
Regarding the expansion of the list of health insurance drugs, Minister Dao Hong Lan said that on November 16, 2024, the Ministry of Health issued Circular No. 37/2024/TT-BYT stipulating the principles, criteria for developing, updating, recording information, list structure and payment instructions for pharmaceutical drugs, biological products, radioactive drugs and markers within the scope of benefits of health insurance participants.
Pursuant to the provisions of Circular No. 37/2024/TT-BYT, the Ministry of Health is urgently reviewing, amending and updating the Circular promulgating the list of drugs to add new drugs with high treatment effectiveness to the list and remove drugs that are no longer suitable from the list. However, the addition of the list of drugs, medical equipment and medical technical services to the scope of benefits for health insurance participants needs to be carefully considered to ensure the payment capacity of the Health Insurance Fund.
Strengthening the application of information technology to resolve policies and regimes for health insurance participants
Responding to the petition of Ninh Binh voters on improving and innovating the management mechanism, enhancing the application of digital science and technology in connecting lines to serve hospital transfers, exploiting medical information related to patients on the network environment, Minister Dao Hong Lan said that recently, the Ministry of Health has chaired and coordinated with relevant ministries and branches to deploy many solutions to enhance the application of information technology to serve the work of resolving regimes and policies for health insurance participants.
Within the framework of Project 06/CP of the Government, from 2023, the Ministry of Health has coordinated with the Ministry of Public Security and Vietnam Social Security to receive patients for medical examination and treatment under health insurance using chip-embedded citizen identification cards or via VNeID, VssID applications, replacing paper health insurance cards and related identification documents, contributing to simplifying administrative procedures and shortening reception time.
Minister Dao Hong Lan said that in 2024, the Ministry of Health will continue to coordinate with the Ministry of Public Security to pilot the use of electronic health insurance referral papers and electronic re-examination appointment papers integrated on the VNeID application, replacing paper documents, creating convenience for patients in referral procedures and re-examination appointments.
According to Minister Dao Hong Lan, the Ministry of Health is currently implementing synchronous digital transformation solutions in the field of health insurance. The Decree providing detailed instructions and measures for implementing the Law on Health Insurance, effective from July 1, 2025, will be the legal basis for promoting activities such as issuing electronic health insurance cards, signing health insurance medical examination and treatment contracts in the electronic environment, direct payment of electronic health insurance medical examination and treatment costs, and conducting electronic health insurance appraisal, in order to improve management efficiency and serve the people.
Source: https://nhandan.vn/bo-y-te-noi-gi-ve-kien-nghi-mo-rong-danh-muc-thuoc-bao-hiem-y-te-post894112.html
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