Payment of medical examination and treatment expenses for patients visiting off-network district, provincial or central hospitals, and then prescribed the inpatient treatment service, is regulated as follows:
- HI fund reimburses them at the coverage rate prescribed in clause 3 or 6 of Article 22 in the Law on Health Insurance for the expenses for hospital's inpatient care prescription that HI participants have paid;
(Inclusive of medical examination and treatment service charges, such as subclinical check-up and testing, medical imaging costs, etc. prescribed or rendered at Outpatient Departments or Emergency Care Departments).
- HI fund does not pay outpatient care costs if HI participants are prescribed inpatient/daylight inpatient care for the same diagnosis results after already receiving outpatient care.
In addition, the Official Dispatch No. 627 also provides instructions about payment of medical care costs in the event that HI participants, of their own choice, make medical visits and are prescribed the daylight inpatient care service.
For more details, please read the Official Dispatch No. 627/BYT-BH dated January 27, 2021.
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