On September 6, according to Hanoi Social Insurance, in the first 7 months of 2025, there were 8,136,033 health insurance examinations and treatments, the cost of health insurance examinations and treatments was VND 16,821.6 billion, accounting for 62.3% of the estimate assigned by the Prime Minister, the number of cases increased by 6.6%, the cost of health insurance examinations and treatments increased by 16.7%.
In particular, some medical facilities have average costs per medical examination and treatment trip for drugs, testing, diagnostic imaging, etc., the rate of inpatients, treatment days is higher than the same period last year and compared to medical facilities at the same level, same specialty and hospital class before.
Currently, Hanoi Social Insurance has signed a health insurance medical examination and treatment (HI) contract with 191 HC facilities (with 732 HC facilities, data connection) to carry out HC work to ensure the rights of health insurance participants. Of which, there are 138 medical examination and treatment facilities under the Department of Health, 53 medical examination and treatment facilities under the Ministry of Health and the Ministries/ Sectors under management; classified by type: 135 public units, 56 non-public units.
To strictly manage the source of health insurance medical examination and treatment costs, Hanoi Social Insurance has fully implemented the directives of Vietnam Social Insurance and Hanoi People's Committee on managing medical examination and treatment costs, at the same time, advised the City People's Committee to issue documents to implement the health insurance medical examination and treatment spending estimate; Law amending and supplementing a number of articles of the Health Insurance Law No. 51/2024/QH15 and Decree No. 188/2025/ND-CP of the Government, especially with a number of contents such as determining transportation costs, determining the cost for a 100% medical examination and treatment visit according to the provisions of the Health Insurance Law to be 15% lower than the basic salary; determining the cost of direct payment and payment...
In addition, Hanoi Social Insurance recommends that medical examination and treatment facilities proactively review and inspect the high cost of health insurance medical examination and treatment, adjust unreasonable things in the prescription of drugs, medical supplies, technical services, prescription of inpatient treatment, etc. to ensure compliance with the provisions of Point b, Clause 1, Article 35 of Decree No. 188/2025/ND-CP dated July 1, 2025 of the Government. Develop and implement specific solutions to strictly control health insurance expenditure for health insurance treatment in the last months of 2025; prevent and combat abuse and profiteering of the health insurance fund.
