The document prescribes that, if health insurance policyholders make medical visits to out-of-network provincial health service providers at their discretion,
- They will be entitled to health insurance coverage for inpatient medical examination and treatment expenses which is equal to that for those expenses incurred at in-network ones;
- They will not be entitled to copayment exemption which is applied to those holding health insurance policies for 5 consecutive years.
Also, copayment amounts paid by patients in this case will not be deemed as the precondition to qualify them for Certificates of copayment exemption in the insured year.
(Benefits for 5 consecutive years' participation in the health insurance plan are only applied to visits to in-network health service providers).
If health insurance cardholders make medical visits to out-of-network health service providers and are prescribed for inpatient treatment services at provincial-level hospitals before January 1, 2021, they will be subject to the following regulations:
In case of being discharged from hospitals from January 1, 2021 onwards, presenting legitimate health insurance cards and personal documents, all insured medical expenses incurred from January 1, 2021 will be covered by the health insurance fund like those incurred at in-network health service providers.
The Official Dispatch No. 4055/BHXH-CSYT is issued on December 23, 2020.
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