[Video] Health insurance pays directly when patients buy medicine and medical equipment themselves in special cases

According to the provisions of Article 60 of Decree No. 188/2025/ND-CP of the Government, patients participating in health insurance will be directly paid by the Social Insurance agency for the cost of purchasing medicine and medical equipment in cases where medical examination and treatment facilities are not available to supply as prescribed by the doctor.

To be eligible for payment, patients must meet all of the following conditions: at the time of prescription or indication of use, the medical examination and treatment facility does not have the drug or medical device, does not have a substitute drug with the same active ingredient, cannot be transferred, transferred or replaced with another device. At the same time, the drug or medical device must be within the scope of benefits of the health insurance participant and must be used at medical examination and treatment facilities within the national health insurance medical examination and treatment system.

The basis for calculating the payment level is a valid purchase invoice, accompanied by a confirmation of shortage of drugs and medical equipment provided by the treatment facility. The payment level shall not exceed the most recent winning bid price at the facility where the patient is treated. In case there is no winning bid price at the facility, the following order of priority shall be applied: results of national and local centralized procurement, or the lowest winning bid price at facilities of the same technical expertise level inside and outside the locality.

Mai Loan - Tuan Tu

Source: https://nhandan.vn/ video -health-insurance-payment-directly-when-people-are-patients-buying-medicine-and-medical-equipment-in-special-cases-post893958.html