Circular 22/2024/TT-BYT regulates the direct payment of drug and medical equipment costs for people with health insurance cards, clearly stating the conditions, criteria and payment levels...
According to the Circular regulating the direct payment of medicine and medical equipment costs for people with health insurance cards who go to see a doctor or receive treatment, people who buy health insurance medicine outside the hospital can be reimbursed by the insurance agency if they meet the conditions.
Ms. Tran Thi Trang - Director of the Health Insurance Department (Ministry of Health) - said: Circular 22 was issued in the context of the draft Law amending and supplementing a number of articles of the Health Insurance Law being submitted to the National Assembly. When the draft Law is passed by the National Assembly, the Ministry of Health will continue to research and review to have more favorable mechanisms and policies to ensure the rights of health insurance participants.
The Ministry of Health is proposing that instead of patients having to pay directly to the Social Insurance agency, there should be a mechanism for hospitals to pay patients, then the hospitals pay back to the Social Insurance agency, to reduce procedures for patients.
The documents and procedures for direct payment include photocopies (with originals for comparison): Health insurance card, identity card; hospital discharge papers, medical examination form or medical examination book; invoices and related documents.
Direct payment procedure: The patient or relative (or legal representative) directly submits the application to the district-level Social Insurance agency where they reside. The district-level Social Insurance agency is responsible for receiving the patient's payment request and issuing a receipt. If the application is not complete according to regulations, instructions will be provided for complete supplementation.
To be paid for health insurance, the buyer must present to the Social Insurance agency a valid prescription or medical supplies prescribed by a doctor as the basis for payment. The Social Insurance agency is responsible for receiving the application and paying the patient directly for the cost of the purchase within 40 days. In case of non-payment, a written response must be given stating the reason.
This Circular takes effect from January 1, 2025. In case a patient enters a medical examination and treatment facility for examination and treatment before the effective date of this Circular but ends treatment after the effective date of this Circular, the provisions of this Circular shall apply.
