Ms. Nguyen Thi Lan (45 years old, Hanoi) said that last weekend, her child had a high fever, so the family took him to the hospital for examination. Initially, she was quite worried because she thought that examination on a holiday would not be covered by health insurance (HI).
I thought that on Saturdays and Sundays the hospital would only provide service examinations, people with health insurance would not be reimbursed, so I also prepared money. After completing the procedures, medical staff instructed that this was a prescribed examination and I was still entitled to health insurance benefits," Ms. Lan shared.
Not only Ms. Lan, many people participating in health insurance are also wondering whether medical examination and treatment on holidays and weekends will still be entitled to benefits.
Medical examination on holidays is still entitled to health insurance if conditions are met
According to the 2024 Law on Health Insurance and Decree No. 188/2025/ND-CP, the health insurance fund pays for medical examination and treatment costs within the scope of benefits and benefit levels of participants. Payment does not depend on whether the patient goes for examination on a working day or a holiday.
However, health insurance benefits also depend on many factors such as whether medical facilities have signed health insurance medical examination and treatment contracts or not, whether patients are examined at the right or wrong tuyến, as well as emergency or regular examination cases.
According to Vietnam Social Security, people with health insurance cards are still paid medical examination and treatment costs by the health insurance fund on holidays, weekends or public holidays if they come for examination at a medical facility with a health insurance medical examination and treatment contract and present a valid health insurance card.
This means that if a hospital or medical facility organizes out-of-hour health insurance examinations, patients still enjoy the same benefits as when examining on a normal working day.
Cases paid by the health insurance fund
Emergency cases;
Medical examination at the right tuyến on holidays;
Out-of-line examination on a holiday: In case the patient voluntarily comes for examination at a medical facility other than the initially registered place without a referral letter and is not in an emergency case, the payment will be applied according to regulations on out-of-line medical examination and treatment.
Notes to avoid losing health insurance benefits
To be fully paid by the health insurance fund, people need to:
Present valid health insurance cards and personal papers as prescribed when completing medical examination procedures.
Inspect in advance whether the medical facility has implemented health insurance out-of-hours or on holidays.
Keep invoices and medical examination and treatment documents if they fall under the case of having to pay directly to the social insurance agency.
For emergency cases, it is necessary to ensure that the emergency status is confirmed by the doctor in the medical record.
