Proposal to abolish referral letters for some patients, still enjoy 100% health insurance

Hà Lê |

The Ministry of Health speaks out about the proposal to exempt referral papers for some groups of subjects when conducting in-depth medical examination and treatment.

Consider expanding social security policies for the elderly

Voters in Phu Tho province proposed that the State study reducing the age of enjoying social security policies from 75 to 70 years old for some groups such as veterans, former youth volunteers and frontline civilians. These are subjects who are currently not poor households, near-poor households, ethnic minorities or residing in border and island areas.

The Ministry of Health has issued a document responding to voters' petitions in Phu Tho province related to expanding health insurance benefits (HI) for some specific groups, including a proposal to allow medical examination and treatment at specialized medical facilities without a referral letter but still fully enjoy HI benefits.

The Ministry of Health said that according to Decree 176, from July 1, 2025, elderly people aged 75 and over or from 70 to under 75 years old from poor households and near-poor households will be considered for social pension benefits if they do not receive a pension or monthly social insurance allowance and have a written request to receive the allowance according to regulations.

The Ministry of Health affirmed that reducing the age for enjoying allowances and expanding the beneficiaries in the past time is a great effort of the Party and State to ensure social security in the context that budget resources are still facing many difficulties. At the same time, this agency will continue to coordinate with relevant units to research and propose to improve policies in the process of amending regulations on social insurance.

Proposal to exempt referral papers when conducting in-depth medical examinations

In addition, voters also proposed to allow the above-mentioned groups to be examined and treated directly at specialized medical facilities without a referral letter from provincial-level hospitals, even for diseases not on the list of dangerous diseases or rare diseases prescribed by the Ministry of Health.

Currently, the policy of health insurance tuyến transfer and tuyến thông is being built to ensure the rights of insurance participants, while effectively using the health insurance fund and limiting overload at upper-level hospitals.

According to the Ministry of Health, health insurance participants have been approved for provincial-level medical examination and treatment nationwide. In particular, from January 1, 2025, Circular 01/2025 has issued a list of 62 dangerous and rare diseases. People with diseases in this list are allowed to have medical examination and treatment at specialized or central-level medical facilities without a referral letter, and are still entitled to full health insurance payment as prescribed.

However, regarding the proposal to expand the mechanism of exemption from referral papers for all diseases at specialized levels, the Ministry of Health said that it is necessary to continue to study and evaluate carefully. This expansion may affect the patient reception capacity of upper-level hospitals, the quality of medical examination and treatment, as well as the balancing capacity of the health insurance fund.

More diseases will be directly examined at the central level

The Ministry of Health said that this agency is requesting localities and medical facilities to assess the results of implementing Circular 01 after more than a year of application, especially the regulations related to the list of 62 rare and critical diseases that can be examined and treated directly at specialized facilities without a referral letter.

According to the plan, this year the Ministry of Health will issue a circular amending and supplementing some contents of Circular 01. It is expected that many rare diseases and new dangerous diseases will be included in the list, creating conditions for patients to access specialized treatment facilities from the beginning, reducing waiting time, travel costs and financial burdens in the treatment process.

Hà Lê
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