What is the level of health insurance coverage?

Question:

I registered for medical examination and treatment in this district, but if I go for treatment in another district within the same city, will I still be covered by health insurance? – Mr. Tran The Quynh (Hanoi).

Vietnam Social Security responds:

According to Article 22 of the Health Insurance Law, if you initially registered for health insurance in this district but went for medical examination and treatment at a medical facility in another district within the same city, and completed all health insurance procedures (presenting your health insurance card and identification documents with a photo), the health insurance fund will reimburse you as follows:

If you initially registered for health insurance at a district-level hospital/polyclinic/commune-level health station:

- When receiving medical examination and treatment at district-level hospitals/multi-specialty clinics/commune-level health stations, 100% of the medical examination and treatment costs will be covered by the health insurance fund within the scope of coverage and the benefit level indicated on the health insurance card.

- When receiving medical treatment at a provincial-level hospital, the health insurance fund will cover 100% of the inpatient treatment costs within the coverage limits of the health insurance fund and the benefit level indicated on the health insurance card; the health insurance fund will not cover outpatient treatment costs.

- When receiving medical treatment at central-level hospitals, the health insurance fund covers 40% of inpatient treatment costs within the scope of coverage of the health insurance fund and the benefit level indicated on the health insurance card; the health insurance fund does not cover outpatient treatment costs.

If you initially registered for health insurance at a provincial/central-level hospital:

- When receiving medical treatment at central-level hospitals: the health insurance fund covers 40% of inpatient treatment costs within the scope of coverage of the health insurance fund and the benefit level indicated on the health insurance card; the health insurance fund does not cover outpatient treatment costs.

- When receiving medical treatment at a provincial-level hospital: the health insurance fund will cover 100% of inpatient treatment costs within the coverage limits of the health insurance fund and the benefit level indicated on the health insurance card; the health insurance fund will not cover outpatient treatment costs.

- When receiving medical examination and treatment at district-level hospitals: the health insurance fund will cover 100% of the medical examination and treatment costs within the scope of coverage of the health insurance fund and the benefit level indicated on the health insurance card.

- Medical examination and treatment at polyclinics or commune health stations: Medical examination and treatment costs are not covered by health insurance.

Source: https://kinhtedothi.vn/kham-benh-khac-noi-dang-ky-ban-dau-trong-cung-tinh-tp-muc-huong-bhyt-the-nao.html