The level of health insurance benefits (BHYT) is determined based on the place of initial medical examination and treatment registration.
Mr. Le Van Hoang (Ho Chi Minh City) registered for initial medical examination and treatment at Hoc Mon General Hospital. He was diagnosed with a lipoma on his left ankle, and after unsuccessful medication, the doctor advised him to undergo surgery for removal.
The upfront payment for the hospital admission was 5,000,000 Vietnamese Dong, and upon discharge, he was refunded 1,225,000 Vietnamese Dong. The surgical invoice amounted to 2,400,000 Vietnamese Dong. According to Mr. Hoang's research, the cost of the lipoma surgery is covered by health insurance (BHYT), but he did not receive reimbursement from BHYT when making the payment upon discharge. Mr. Hoang requested clarification from the relevant authorities to better understand the situation.
Regarding this matter, the Vietnam Social Insurance responded as follows:
Based on the information provided, Mr. Hoang visited the designated initial medical examination and treatment location stated on his health insurance card, which is Hoc Mon General Hospital (a public district-level healthcare facility) for medical services. Therefore, he is entitled to have 100% of his medical expenses covered by the health insurance fund within the scope and coverage specified on his health insurance card for inpatient treatment and to undergo the technical services as prescribed by the specialist physician.
However, due to insufficient information provided by Mr. Hoang, the Social Insurance agency does not have enough basis to address his concerns. They recommend that he bring the entire dossier, along with the invoices and supporting documents related to the mentioned treatment, to the district-level Social Insurance agency at his place of residence for further examination and clarification of his concerns.
By: Translator: LeAnh-Bizic
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