What conditions are required for patients to enjoy 100% health insurance coverage for medical examination and treatment costs?

'Let me ask, to enjoy 100% of medical examination and treatment costs covered by health insurance at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, what are the conditions?'. (T.Hong, in Ho Chi Minh City).

Master - Doctor Nguyen Thai Hoc, Deputy Head of Health Insurance Department, University of Medicine and Pharmacy Hospital, Ho Chi Minh City, answered: From January 1, 2025, University of Medicine and Pharmacy Hospital, Ho Chi Minh City is a high-tech specialized hospital. Therefore, to enjoy 100% health insurance benefits at University of Medicine and Pharmacy Hospital, Ho Chi Minh City, patients need to have all the following documents:

Patients are doing health insurance procedures at University of Medicine and Pharmacy Hospital, Ho Chi Minh City

Photo: M.Tri

For outpatient examination and treatment:

• Information about health insurance card.
  
• Photo identification.
• Medical examination and treatment facility transfer form for health insurance in accordance with regulations.
  

In case the patient is diagnosed and treated for a number of rare diseases, serious diseases, diseases requiring surgery or using high technology according to the list in Appendix I, Circular 01/2025/TT-BYT and meets the following conditions:

• Information about health insurance card.
  
• Photo identification.

* For inpatient examination and treatment:

• Information about health insurance card.
  
• Photo identification.

How does health insurance pay for out-of-network medical examination?

Master - Doctor Nguyen Thai Hoc said that when examining and treating patients with health insurance at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, patients have the following benefits:

For outpatient examination and treatment:

• On-line: 100% of the benefit level according to the card code.
• Left line: 0%.

For inpatient examination and treatment:

• On-line: 100% of the benefit level according to the card code.
• Off-line: 100% of the benefit level according to the card code.

Source: https://thanhnien.vn/nguoi-benh-huong-100-chi-phi-kham-chua-benh-bao-hiem-y-te-can-dieu-kien-gi-185250710181820036.htm