Ca Mau: Health insurance medical examination and treatment costs are estimated to exceed the budget by about 255 billion VND.

Tam Duc Dam Doi General Clinic (Dam Doi Commune, Ca Mau Province) has seen a "huge" increase in the number of medical examinations and treatments and the amount of money requested for insurance payment.

According to the Social Insurance of Ca Mau province, the total estimated budget for 2025 of Ca Mau province assigned by Vietnam Social Insurance is 2,613 billion VND. As of the end of September 2025, the total cost of medical examination and treatment under health insurance (HI) is over 2,100 billion VND (accounting for 81% of the total estimate). It is estimated that in the whole year of 2025, the total cost of medical examination and treatment under HI in Ca Mau province will exceed about 255 billion VND (nearly 10%).

Through the assessment of the implementation of health insurance examination and treatment expenditures in the first 9 months of 2025, there were 21 medical examination and treatment facilities with an increase in the amount of proposed insurance payment, higher than the general rate of the whole Ca Mau province (compared to the same period in 2024). Among these, there were medical examination and treatment facilities with increases such as: Thien Phuc General Clinic: the number of medical examinations and treatments increased by 528%, the amount of proposed insurance payment increased by 662%; Anh Kiet General Clinic: the number of medical examinations and treatments increased by 342%, insurance payment increased by 445%; Tam Duc Dam Doi General Clinic: the number of medical examinations and treatments increased by 294%, insurance payment increased by 394%.

Also according to Ca Mau Provincial Social Insurance, in the first 9 months of 2025, the cost of health insurance bed payments in the whole province increased by more than 25%, the average cost of inpatient bed payments increased by more than 15%; the rate of using the estimated budget in the whole province was 82%.

Faced with the above reality, Ca Mau Social Insurance requested medical facilities to analyze and determine the reasons for the increase in costs at each medical facility, each form of medical examination and treatment (inpatient and outpatient); each clinical department. Make adjustments to effectively use the health insurance fund, in accordance with regulations.

TAN THAI

Source: https://www.sggp.org.vn/ca-mau-chi-phi-kham-chua-benh-bhyt-uoc-vuot-du-toan-khoang-255-ty-dong-post823232.html