Ensuring benefits of health insurance card holders when medical facilities are on lockdown

07/04/2020 09:05 AM

To best maintain medical examinations and treatment for holders of health insurance cards, Viet Nam Social Security has issued document no. 1072/BHXH-CSYT on ensuring benefits of health insurance card holders when medical facilities are on lockdown or switch to exclusively treat COVID-19 patients.

Benefits of people who hold health insurance cards will be ensured when medical facilities are on lockdown.

Illustrative Photo

Due to the complicated developments of COVID-19, provincial branches asked Viet Nam Social Security to come up with solutions to ensure benefits of health insurance card holders when local medical facilities are quarantined or tasked to admit, screen, quarantine and treat infections/suspected infections of COVID-19.

On April 1, Viet Nam Social Security issued Document No 1072/BHXH-CSYT, asking provincial branches to collaborate with departments of health to provide medical examination and treatment or transfer patients using health insurance cards in case local medical facilities are quarantined or tasked to admit, screen, quarantine and treat infections/suspected infections of COVID-19.

In case the medical facility is a provincial or tertiary referral hospital, a health insurance card holder can choose to transfer to a same or lower level hospital in the same area and medical expenses will be covered by the health insurance fund as normal.

For patients who are quarantined at mentioned medical facilities yet suffer other diseases or those who are undergoing treatment for other diseases yet their medical facilities are on lockdown, their medical expenses from the day the medical facilities are quarantined or tasked to admit, screen, quarantine and treat infections/suspected infections of COVID-19 will be covered following the Ministry of Health’s instruction stated in Document No 505/BYT-BH of February 6, 2020.

Medical facilities which are quarantined or tasked to admit, screen, quarantine and treat infections/suspected infections of COVID-19 are asked to update medical expenses covered by the health insurance fund to the health insurance information inspection system right after a patient is discharged for the agency to inspect, calculate and pay the expenses.

Amid COVID-19, following orders of Prime Minister Nguyen Xuan Phuc, Viet Nam Social Security promptly developed solutions to protect benefits of health insurance participants and contribute to fight the disease.

***Earlier, on February 6, 2020, Ministry of Health issued Document No 505/BYT-BH on the payment of medical expenses for treatmentof pneumonia caused by the new strain of coronavirus. According to Circular No 32/2012/TT-BTC of December 29, 2012 issued by Ministry of Finance, people infected, suspected of being infected with the virus and high-risk people will have medical expenses fully covered.

Mentioned cases are identified following the Ministry of Health’s instructions on diagnosing and treating COVID-19. The list of medical supplies and medicines is made following a regulation of the Department of Medical Examination and Treatment Management on medical supplies and medicines for isolation treatment units.

Besides, for people who suffer other diseases that need treatmentwhile under isolating measures regulated in the Government’s Decree no 101/2010/NĐ-CP of September 30, 2010 about guidelines on the Law on Prevention of Infectious Diseases or whose medical facilities are quarantined while they are undergoing treatment for other diseases, the payment of medical expenses will be addressed as follows:

For patients with health insurance cards, the health insurance fund will pay for treatment of other diseases within the scope of benefits and the level of health insurance allowance like for emergencies, except for medical expenses that have been exempted for COVID-19-confirmed cases.

In addition, if the patient is treated at a place where there is no contract of medical examination and treatment with health insurance, he/she shall be directly paid by the health insurance fund within the scope of benefits and benefit level of health insurance like in the case of emergency, except for exempted medical examination and treatment expenses for cases involving COVID-19. Patients without health insurance cards must pay for the cost of other medical treatment according to the law on medical examination and treatment services.

In case patients have examinations and treatments at medical facilities that are not required to apply medical isolation, the patient who has health insurance card will have medical expenses covered by the health insurance fund in accordance with the law on health insurance. For those without health insurance cards, they must pay for themselves according to the provisions of the law on medical examination and treatment servicesf./.