Previously, many health insurance (HI) participants who wanted to be examined and treated at upper-level hospitals had to have a referral letter if they did not want to lose their benefits. However, from July 1, 2026, a series of new regulations officially took effect, significantly expanding the rights of patients, especially in outpatient visits and referrals.
Outpatient examination outside the tuyến is still covered by health insurance
One of the most notable changes is that health insurance participants who go for outpatient examinations outside the line at some basic and specialized level medical examination and treatment facilities will be paid 50% of the benefit level according to the health insurance card by the health insurance fund.
This policy applies to diseases and disease groups according to regulations, helping to reduce the cost burden for patients when they need to be examined at provincial or central hospitals without having to complete the referral process as before.
62 diseases without referral papers are still entitled to full health insurance benefits
Another important new point is that people with 62 dangerous and rare diseases according to the list prescribed by the Ministry of Health can go directly to provincial or central hospitals for examination and treatment without a referral letter.
In this case, patients still fully enjoy health insurance benefits such as going for examination at the right tuyến, contributing to shortening the time to access treatment for diseases requiring specialized intervention.
Transfer paper digitized, only valid for 10 working days
From July 1, 2026, referral letters will not only be issued in paper form but also synchronized to the health insurance system and the VNeID application, helping medical facilities receive information quickly and limit document loss.
However, patients need to note that the referral letter is only valid for 10 working days from the date of signing. If they have not come to the transferred medical facility after this deadline, patients may have to apply for a re-issuance of the referral letter.
Still have to transfer according to the correct order in normal cases
For cases that are not classified as dangerous diseases or special cases as prescribed, health insurance participants must still undergo medical examination and treatment according to the referral process.
The referral is carried out in order from the lower level to the adjacent upper level, including level 4 to level 3, level 3 to level 2 and level 2 to level 1, in order to ensure compliance with regulations and fully enjoy health insurance benefits.
To avoid affecting their rights, people should proactively look up information about medical examination and treatment facilities, referral regulations as well as health insurance benefit rates on the information portal of Vietnam Social Security or contact medical facilities directly before going for examination. Understanding the new regulations will help make the medical examination and treatment process more convenient, while significantly reducing treatment costs.
