Law on Health Insurance revised to provide more benefits for patients

Patients diagnosed to suffer certain rare diseases, serious diseases, or diseases requiring surgery or advanced technology application may have examination and treatment costs wholly covered by the health insurance fund at the law-specified benefit levels without having to go through hospital referral as under current regulations.

Such is highlighted in the 2024 Law amending a number of articles of the 2008 Law on Health Insurance.

Under the Law, patients as health insurance buyers would also be entitled to full coverage of medical expenses if they (i) receive medical examination and treatment at health insurance-covered primary care providers nationwide; (ii) undergo inpatient treatment at health insurance-covered basic healthcare facilities nationwide; or (iii) receive medical examination and treatment at health insurance-covered basic or specialized medical facilities that had been recognized as district-level health facilities before January 1 this year.

The Law adds provisions on registration of primary care providers, saying that persons covered by health insurance may choose and register for receiving medical care services at basic or primary healthcare facilities. They may also change the registered primary care providers within the first 15 days of every quarter. The allocation of health insurance cards to primary care providers will be based on people’s needs, capacity of healthcare facilities, as well as practical situation of localities.

Noteworthily, the Law expands the coverage of compulsory health insurance to employees working under a labor contract of full one month or more, including also those working under agreements that bear other names but show paid jobs with the supervision of compulsory health insurance participants in the capacity as one party.

In addition, subject to compulsory health insurance are healthcare workers or midwives in villages; individuals joining grassroots security and order protection forces; persons aged 75 years or older who currently receive monthly survivorship allowance; and persons aged between full 70 and under 75 years of households just above the poverty line who currently receive monthly survivorship allowance.

By: VLLF