Unlimited number of insurance-covered visits per day

The Ministry of Health said that there is currently no regulation limiting the number of health insurance examinations and treatments per day at the same facility, but there is a restriction on registration for initial examinations and treatments at the specialized level.

Get health insurance re-examination on the same day at the same facility

Recently, the Ministry of Health has received opinions from voters, stating that health insurance examination and treatment twice a day without applying the health insurance regime is inappropriate. Therefore, voters proposed to have regulations for some cases and diseases that do not limit the number of health insurance examinations and treatments per day.

Restricting registration for initial medical examination and treatment at specialized facilities

PHOTO: DINH HUY

In response, the Ministry of Health affirmed that current health insurance laws do not limit the number of health insurance examinations and treatments per day.

According to current regulations, in case a patient comes to a medical facility for examination and treatment, has been examined and given medication but then shows abnormal symptoms, returns to the same facility for examination on the same day and is continued to be examined, this visit is considered the second visit onwards in the day. Emergency cases are counted as a new visit.

Payment for medical examination costs is made at a maximum payment level of no more than 2 times the price of one medical examination. This regulation aims to ensure the legitimate rights of health insurance participants, medical examination and treatment facilities and the payment capacity of the Health Insurance Fund.

Restricting registration for initial medical examination and treatment at the specialized level

Regarding the right to health insurance examination and treatment when changing the place of residence, the Ministry of Health said that current regulations on cases of residence and procedures for health insurance examination and treatment when changing the place of residence or temporary residence ensure the right to benefits when the place of residence is not in the area of ​​initial medical examination and treatment registration.

This ensures the rights of students during summer vacation and workers during family leave.

Accordingly, health insurance participants are entitled to 100% of the benefits when examining and treating at primary and basic health insurance examination and treatment facilities other than the place of initial health insurance examination and treatment registration, regardless of administrative boundaries.

However, initial health insurance medical examination and treatment registration is currently mainly at the initial medical examination and treatment level, partly at the basic level, and limited at the advanced level to contribute to strengthening health insurance medical examination and treatment at the grassroots medical level.

In cases where a follow-up appointment is required, the medical examination and treatment facility must record the content and schedule of the follow-up appointment in the follow-up appointment slip (paper or electronic copy). Each follow-up appointment slip can only be used once.

The patient is responsible for arriving at the medical examination and treatment facility at the correct time stated on the re-examination appointment card. In case the patient cannot arrive at the correct appointment time, he/she must contact the treating physician or the medical examination and treatment facility to make another suitable appointment.

Source: https://thanhnien.vn/khong-gioi-han-so-lan-kham-thanh-toan-bao-hiem-trong-ngay-185250326183450524.htm