Health insurance benefits when examining at Bach Mai Hospital, Ninh Binh facility without a referral letter

Hà Lê |

Bach Mai Hospital in Ninh Binh branch deploys health insurance medical examination and treatment; benefit level when there is no referral letter depending on the case.

Bach Mai Hospital said that it has signed a health insurance (HI) medical examination and treatment contract with Hanoi City Social Insurance to deploy HI medical examination and treatment at Ninh Binh facility right from the opening day.

Cases eligible for 100% of health insurance benefits

People with health insurance cards are paid 100% of the benefit level by the health insurance fund according to the scope of benefits in some cases such as:

Medical examination and treatment in an emergency situation.

Have a valid medical examination and treatment facility transfer slip.

There is a re-examination appointment book issued by Bach Mai Hospital.

Newborns must be treated immediately after birth.

People who have donated body parts must be treated immediately after donating.

How can health insurance be enjoyed if you come for self-examination without a referral letter?

Bach Mai Hospital in Ninh Binh is a specialized level medical examination and treatment facility. Therefore, if patients come for self-examination without a transfer paper to the medical examination and treatment facility as prescribed, the health insurance benefit level will depend on the treatment form and specific case.

For outpatient examination: People with diseases under Appendix I and meeting the conditions according to Clause 3, Article 5, Circular 01/2025/TT-BYT are not required to carry out procedures for transferring to medical examination and treatment facilities and are paid 100% of the benefit level by the health insurance fund for diseases on the list. Other cases are not paid by the health insurance fund for outpatient examination.

For inpatient treatment: People with diseases under Appendix I and meeting the conditions according to regulations are entitled to 100% of the benefit level for diseases on the list. People with residence codes K1, K2, K3 on the health insurance card are also entitled to 100% of the benefit level according to the scope of benefits.

The remaining cases are paid 40% of the benefit level according to regulations by the health insurance fund when receiving inpatient treatment at specialized medical examination and treatment facilities.

100% benefit level does not mean that health insurance pays 100% of all medical examination and treatment costs. The amount paid by the health insurance fund also depends on the scope of benefits, benefit level recorded on the card and current regulations.

Are health insurance benefits in Ninh Binh the same as in the Hanoi facility?

According to Bach Mai Hospital, people with health insurance cards for medical examination and treatment at Ninh Binh facilities are guaranteed health insurance benefits according to regulations, equivalent to medical examination and treatment at Hanoi facilities.

Ninh Binh facility is guaranteed in terms of facilities, equipment, human resources and professional capacity. Professional procedures and quality standards are implemented uniformly in the Bach Mai Hospital system.

When will the patient be transferred to Bach Mai Hospital?

Patients can be transferred to Bach Mai Hospital when there are professional indications suitable to the patient's condition, treatment requirements and regulations on health insurance patient transfer.

The transfer of medical examination and treatment facilities is carried out based on the prescription of medical staff, ensuring compliance with the disease status and treatment needs.

Patients who are receiving outpatient treatment or inpatients who have been discharged from Hanoi facilities, if residing in Ninh Binh and surrounding areas, may be guided by medical staff and scheduled for re-examination and periodic monitoring at Ninh Binh facilities.

Professional procedures, treatment instructions and drug lists are unified between the two facilities. Thanks to this, patients can continue to be managed and treated according to the same professional standards, while reducing travel time and costs.

Hà Lê
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