Before the 6th session of the 15th National Assembly, voters in Bac Giang province proposed an issue regarding people who purchase local health insurance but get sick or injured while they are traveling or doing business in other provinces. In these cases, the local healthcare facility cannot fully reimburse the medical expenses due to the cross-district regulation.
Voters suggested considering and adjusting the nationwide coverage of health insurance to avoid disadvantages for participants.
Voters suggested considering and adjusting the nationwide coverage of health insurance. (Illustrative picture)
Regarding the issue of cross-district health insurance regulation, Minister of Health Dao Hong Lan affirmed that, according to regulations, when participants of health insurance travel, study, work, or temporarily reside for less than 12 months in another locality, they can receive medical treatment at healthcare facilities in that locality equivalent to the level of healthcare facilities initially recorded on their health insurance cards.
If there are no equivalent healthcare facilities available in that locality, participants of health insurance can choose other healthcare facilities that accept health insurance. “In this case, it is determined to be within the appropriate health insurance coverage, and participants can fully enjoy the health insurance benefits according to the prescribed amount,” stated the Minister.
Regarding the nationwide coverage of health insurance, Minister Lan informed that participants of health insurance have been granted access to district-level and provincial-level healthcare facilities nationwide. As for the expansion of the nationwide coverage to the central level, the Minister said that further research and consideration are needed to avoid overloading the central level, strengthen healthcare services covered by health insurance at the grassroots level, and ensure the balance of the Health Insurance Fund.
According to the provisions of the Health Insurance Law, starting from January 1, 2016, participants of health insurance are granted access to district-level healthcare services. This means that people can receive healthcare at any healthcare facility within the district level of the province (Clause 4, Article 22), as well as at district-level hospitals nationwide (Clause 3, Article 22).
Since January 1, 2021, participants of health insurance are granted access to provincial-level healthcare services nationwide, meaning that people can receive inpatient treatment at provincial-level healthcare facilities throughout the country.
