These 3 students participate in health insurance in Ho Chi Minh City, Hanoi and Tien Giang. These are cases where the health insurance fund pays from 1.04 – 1.07 billion VND for medical examination and treatment costs. Many other cases were also paid from 100 million to nearly 1 billion VND.
Thousands of students have major medical examination and treatment costs covered by the health insurance fund
Information from Vietnam Social Security on the morning of September 22 said that in 2022 and the first 8 months of 2023, many cases of students going for medical examination and treatment have had large treatment costs covered by the health insurance fund, specifically Can:
The cost range from 100 – 200 million has 1,435 students/15,620 medical examinations, the cost paid by the health insurance fund is 194.4 billion VND.
The cost level is from 200 – 500 million VND with 568 students/6,489 medical examinations, the cost paid by the health insurance fund is 165.5 billion VND.
The cost is from over 500 million VND with 66 students/817 medical examinations, the cost paid by the health insurance fund is 43 billion VND.
Some cases of students having large treatment costs covered by the health insurance fund (in 2022 and the first 8 months of 2023) are as follows:
The patient with the highest payment from the health insurance fund is 1.07 billion VND (in 2022): card code HS4797937XXXXXX, born in 2006, address 18A Do Doc Long, Tan Quy ward, Tan Phu district, Ho Chi Minh City; The main diagnosis is “Disease of the eye socket, Acute myocarditis, Sequelae of intracranial damage”.
The patient with the second highest payment from the health insurance fund is 1.04 billion VND (in 2022): card code HS4828222XXXXX, born in 2008, address Duong Diem commune, Chau Thanh district, Tien Giang province; The main diagnosis of the disease is “Hereditary factor VIII deficiency, severe dengue fever”.
Another case, also paid 1.04 billion VND by the health insurance fund (of which 0.66 billion VND will be paid in 2022, 0.38 billion VND will be paid in the first 8 months of 2023): card code HS4013520XXXXX, born 2014, address 12 Hoang Hoa Tham, Ba Dinh district, Hanoi city; The main diagnosis is “Liver fibrosis, Cholangitis, Biliary atresia…”.
Patient is paid 0.92 billion VND by the health insurance fund (of which 0.69 billion VND will be paid in 2022, 0.23 billion VND will be paid in the first 8 months of 2023): card code HS4010123XXXXX, born in 2007, address Gia Thuy ward, Long Bien district, Hanoi city; The main diagnosis is “Non-specific meningococcal septicemia, other acute viral hepatitis, idiopathic bone marrow failure…”.
According to Vietnam Social Insurance, in recent years, students’ medical and health insurance benefits have always been guaranteed and in accordance with regulations. According to statistics in the two years 2021 and 2022, on average each year the country has nearly 3 million students using health insurance cards with about 6.1 million health insurance medical examinations, the total health insurance medical examination costs of the student group. The average per year is more than 2,500 billion VND.
In the 2022-2023 school year, the country will reach more than 97% of the total number of students participating in health insurance. This result means that over 18.8 million students are guaranteed and fully enjoy health insurance benefits according to regulations. In particular, if they are unfortunately sick, have an accident… they will be paid by the health insurance fund with an unlimited amount of medical treatment within the scope and level of benefits.
In fact, there have been many cases of students suffering from incurable and chronic diseases that require long-term treatments such as hemodialysis, cancer treatment, cardiovascular surgery, etc., which have been funded by the fund. Health insurance payments range from tens of millions to billions of dong. Thanks to that, it will help their families reduce the financial burden as well as give them more motivation and peace of mind to treat their illness so they can return to study soon.
Statistics show that in 2022 alone, the whole country will have about 3.5 million students receiving medical treatment under health insurance with nearly 7.4 million medical examinations, the amount paid by the health insurance fund is 3,142 billion VND.
It can be affirmed that health insurance is a social security policy with practical and important meaning, contributing effectively to medical examination and treatment, health care for students in particular and the people in general. Participating in student health insurance is not only to take care of and protect the health of the younger generation, but also to demonstrate their responsibility to comply with the law and their spirit of solidarity to share risks with those who are unfortunate. face health risks.
What is the level of health insurance benefits?
First, when a student goes for medical treatment at a medical facility that has signed a medical insurance contract:
In case the health insurance medical examination is at the original registration place and complete procedures are carried out for students with health insurance card benefit code of 4, they will receive 80% of medical examination costs.
In case the health insurance medical examination is not at the right level: The patient does not have a referral certificate but presents complete health insurance medical examination procedures and will be paid by the health insurance fund within the scope, benefit level and ratio as prescribed as follows:
Technical professional route
Type of medical treatment
Benefit rate
(medical expenses)
District hospital
Outpatient, Inpatient
100%
Provincial hospital
Boarding
100%
Central Hospital
Boarding
40%
In case the health insurance medical examination does not present complete procedures at the initial medical examination registration place, the social insurance agency will directly pay the health insurance medical examination costs for the following cases:
- Outpatient medical examination, maximum benefit is not more than 0.15 times the base salary (equivalent to 270,000 VND).
- Inpatient medical treatment, maximum benefit is not more than 0.5 times the base salary (equivalent to 900,000 VND).
Second, when students go for medical treatment at a medical facility that does not have a medical insurance contract:
The social insurance agency will directly pay health insurance medical examination and treatment costs for the following cases:
Outpatient medical treatment at district hospitals is entitled to a maximum of 0.15 times the base salary (equivalent to 270,000 VND).
Inpatient medical care at district hospitals is entitled to a maximum of 0.5 times the base salary (equivalent to 900,000 VND).
Inpatient medical care at provincial hospitals are entitled to a maximum of 1 time the base salary (equivalent to 1,800,000 VND).
Inpatient medical care at central hospitals receive a maximum of 2.5 times the base salary (equivalent to 4,500,000 VND).
Third, other special cases are paid directly by the social insurance agency according to the scope of benefits of health insurance participants , specifically:
Health insurance card data is not provided or inaccurate health insurance card information is provided. The patient cannot present the health insurance card before leaving the hospital, is transferred to the hospital on the same day due to an emergency, loss of consciousness or death, or has lost the card but has not had it reissued.
People who have participated in health insurance for 5 consecutive years or more, have the amount of money they have paid for on-line medical care in the year is greater than 6 months of base salary, but have not been paid the amount of money they have paid together is greater than 6 months of base salary.
In case of emergency at a health care facility that does not sign a health insurance health care contract.
Fourth, emergency cases:
Students receive medical treatment at any medical facility and must present their health insurance card and photo identification before leaving the hospital to receive health insurance benefits according to regulations.
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