Proposal for 7 groups of people for home examination to still be covered by health insurance

Hà Lê |

The new draft of the Ministry of Health proposes to expand health insurance benefits (HI), allowing 7 groups of people to receive medical examination and treatment at home and still be paid by the HI Fund.

The Ministry of Health is seeking opinions on the draft Circular regulating health insurance (HI) payment for family medical examination and treatment, home examination and treatment, and remote examination and treatment. One of the notable new points is the proposal for the HI Fund to pay for home examination and treatment costs for some groups of patients with special care needs.

According to the draft, home medical examination and treatment is carried out when the medical examination and treatment facility has signed a health insurance contract and sends a doctor or medical staff to the patient's residence for examination and treatment. The residence can be a private house, a public social protection center or another location as prescribed by law.

The draft proposes 7 groups of beneficiaries of this policy, including: people with severe and especially severe disabilities; people aged 75 and over with limited mobility; people with mental illnesses who are unable to take care of themselves; people with chronic diseases with limited mobility or paralysis; patients in need of palliative care in the late stages of life; people who are receiving social protection benefits, wounded soldiers, sick soldiers, people with meritorious services being cared for at social protection facilities or nursing centers; children under 36 months old and elderly people without relatives taking care of them.

Not only are they personally examined by doctors, but subjects under this category are also reimbursed by the Health Insurance Fund for costs of medicines, medical equipment, medical supplies, blood, blood products, medical gases, chemicals and related costs according to the scope of benefits and benefit levels of health insurance participants.

In case of necessity, medical staff are allowed to bring medicine and medical equipment from the medical examination and treatment facility to the patient's residence as directed. If testing is required, medical staff can bring the equipment to their home or take samples at home to transfer to the medical facility for diagnosis.

According to the Ministry of Health, home medical examination and treatment is only carried out by medical examination and treatment facilities that have signed health insurance medical examination and treatment contracts. Practitioners must be assigned tasks in writing by the head of the medical facility and have a professional scope suitable to the service provided.

Currently, Vietnam does not have separate regulations on health insurance payment, service prices, professional procedures, medical records and prescriptions for home-based medical examination and treatment. If the draft is promulgated, this will be the first time there are specific regulations on the Health Insurance Fund paying for home-based medical examination and treatment costs, creating a legal basis to expand the health care model right in the community.

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