Medical examination and treatment at primary health care facilities

Currently, the Department of Health Protection for Officials is initially classified by the competent authority (Department of Health), according to Clause 1, Article 7 of Circular No. 01/2025/TT-BYT, all subjects are registered for initial medical examination and treatment at the initial medical examination and treatment facility. This means that the director of the enterprise can continue to register for initial medical examination and treatment at the Department of Health Protection for Officials. On the other hand, according to the provisions of Law No. 51/2024/QH 15, patients who come to the initial medical examination and treatment are entitled to 100% of the cost within the scope of benefits according to the benefit level. This creates favorable conditions for patients with health insurance to have medical examination and treatment at the initial level, including the Department of Health Protection for Officials.

According to the new law, health insurance participants with diseases listed in the List of some diseases in Appendix I attached to Circular No. 01/2025/TT-BYT who go to specialized medical examination and treatment facilities ( Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital) will enjoy 100% of the costs within the scope of benefits according to the benefit level; health insurance participants with diseases listed in the List of some diseases in Appendix II attached to Circular No. 01/2025/TT-BYT who go to basic medical examination and treatment facilities (hospitals) will enjoy 100% of the costs within the scope of benefits according to the benefit level. This regulation helps patients with serious and critical illnesses easily access medical examination and treatment at basic and specialized medical examination and treatment facilities for some diseases specified in these two Appendices.

If the hospital does not have the medicine in the health insurance list and the patient has to buy medicine from outside, the health insurance fund will reimburse the cost if it meets the conditions prescribed by the Ministry of Health . The Social Insurance Agency has requested medical examination and treatment facilities to ensure the rights of participants when examining and treating patients, so they should limit the requirement for patients to buy medicine.

Notably, administrative procedures are simplified with the digitization of referral forms and follow-up appointment forms. Specifically, integration into the VNeID application helps reduce administrative procedures and create convenience for patients. The number of health insurance cards at primary medical examination and treatment facilities is initially allocated based on people's needs, the service capacity of the medical facility, and the actual local situation.

With the great benefits implemented for the first time from the revised Law on Health Insurance 2024, it can be affirmed that the health insurance policy of the Party and State has penetrated deeply into life, truly for the benefit of the people. The good implementation of the health insurance policy not only improves the quality of medical services but also creates trust and peace of mind for participants when coming to medical examination and treatment at medical facilities.

Article and photos: An Nhien

Source: https://huengaynay.vn/chinh-tri-xa-hoi/an-sinh-xa-hoi/nhung-thay-doi-tich-cuc-tu-luat-bao-hiem-y-te-sua-doi-155693.html