Protecting benefits of the medically insured

“Efficient use of Health Insurance Fund, ensuring rights and benefits of patients and improving the quality of insurance-based health services at healthcare facilities” is the theme of the Vietnam Health Insurance Day (July 1) 2024.

Health Insurance propaganda.

Protecting the insured against financial risks

The health insurance policy helps protect the insured against financial risks associated with paying for health services. Patient Nguyen Thi Tuyet (Nha Trang City) with an abdominal tumor, has just benefited from 80% of the insurance coverage for her treatment at the hospital.

A health insurance policy is primarily designed to cover the insured financially in case of a medical emergency caused by illnesses, accidents or hospitalization. Nguyen Quang Vinh, Vinh Hai Ward, Nha Trang City has just bought health insurance worth VND2.7 million for his 4 members of the family. The insurance takes effect from July 1.

Health insurance policies cover costs incurred while taking treatment in a hospital for any illness, especially serious diseases that need long-term treatment. Some poor patients have benefited up to VND300-600 million/ case which is beyond their financial capacity.

According to the Provincial Social Insurance, in the first 6 months of the year, medical facilities in the province provided medical examination and treatment for 1,512,114 medically insured patients with a total cost of more than VND755.46 billion.

Improving health insurance fund management

Recently, the implementation of health insurance policies in the province has ensured benefits for the medically insured with close coordination among relevant sectors.

The social insurance sector has coordinated with the health sector to carry out medical examination and treatment under health insurance; promote reform of administrative procedures and application of information technology (especially, the use of chip-based citizen identity cards instead of paper health insurance cards) in insured health care services; raise sense of responsibility and quality of patient service, etc.

Health insurance policies are improving, aiming to ensure the highest benefits for the insured. Many high-tech techniques, quality medicines and imaging and testing services have been covered up to 80-90% by health insurance.

According to Pham Xuan Hai, Deputy Director of the Provincial Social Insurance, in 2024, the Provincial Social Insurance will sign health insurance examination and treatment contracts with 37 medical facilities, including 22 public and 15 non-public ones.

The Provincial Social Insurance has strengthened health insurance control measures and coordinated with the Department of Health and the Department of Finance to carry out inspection over the management and use of health insurance funds to promptly prevent health insurance fraud, waste and abuse to protect the rights and benefits of the insured.

Till early June, as many as 1,208,120 people accounting for  94.5% were covered by health insurance. The universal health insurance target is 94.5%. Health insurance is an important policy and a pillar of the social security system.

Towards universal health insurance, multisector efforts are required to promote health insurance propaganda, administrative reform and information technology application in the management and use of health insurance funds; and improve the quality of the insured health care services.

M.H

Translated by N.T