Sending a question to the XXXI Regional Social Insurance, reader N.A.L in Vinh Long asked: "I am a 58-year-old male patient who has voluntarily purchased health insurance. In May 2025, I went to Hanoi to live with my son and suffered a minor stroke, and had a doctor treat him at home. How is my health insurance paid for? ".
Regarding this issue, the XXXI Regional Social Insurance responded as follows:
After studying relevant regulations, his case was not covered by the health insurance fund, because the Health Insurance Law No. 25/2008/QH12 does not stipulate that home medical examination and treatment are entitled to health insurance.
The Health Insurance Fund only pays when health insurance participants go to medical examination and treatment at a medical facility and sign a health insurance examination and treatment contract with the Social Insurance agency "stipulated in Point a, Clause 1, Article 21, Article 22 of the Health Insurance Law No. 25/2008/QH12".
In addition, the Social Insurance agency will pay the cost of health insurance examination and treatment directly to people with health insurance cards when going to a medical examination and treatment facility without signing a health insurance examination and treatment contract; medical examination and treatment are not submitted in accordance with the procedures prescribed in Article 28 of the Law on Health Insurance "Clause 25, Article 1 of the Law on Health Insurance No. 51/2024/QH15 amends Clause 2, Article 31 of the Law on Health Insurance".
However, according to the Law on Health Insurance No. 51/2024/QH15, effective from July 1, 2025, amending Point a, Clause 1, Article 21 of the Law on Health Insurance No. 25/2008/QH12, "disease examination and treatment includes remote medical examination and treatment, support for remote medical examination and treatment, family medicine examination and treatment, home medical examination and treatment, rehabilitation, periodic pregnancy check-ups, childbirth...", this content is waiting for implementation guidance from competent authorities.
