GUIDANCE ON PAYMENT FOR COVID-19 TESTING COSTS ACCORDING TO HEALTH INSURANCE REGIME

Vietnam Social Security (VSS) has just issued Official Letter No. 2731/BHXH-CSYT to the Social security agencies of provinces and cities; Social security agencies of the Ministry of National Defense; Social security agencies of the People’s Public Security about payment for Covid-19 testing costs according to the health insurance regime.

Accordingly, VSS guides the payment for Covid-19 testing costs according to the health insurance regime as follows:

• Firstly, for people subject to medical isolation measures prescribed in Clauses 2, 3 and 4 Article 1 of Decree No. 101/2010/ND-CP
  => The health insurance fund does not pay for the Covid-19 testing costs.
• Secondly, for people with health insurance cards who come for medical examination and treatment at health facilities that are designated to test Covid-19 according to instructions for diagnosis and treatment of acute respiratory infections caused by Covid-19, issued together with the Decision No. 3351/QD-BYT dated July 29, 2020 of the Ministry of Health, including:
  • The patient has a fever and/or acute respiratory infections, unexplained by other causes;
  • Patients with any respiratory symptoms and a history of arriving/passing/staying in/returning from Covid-19 epidemiological areas about 14 days before symptom onset or close contact with a suspected case to suspect or identify Covid-19 within 14 days before symptom onset.

  => The Covid-19 testing costs of these cases is paid as follows:

• With a positive test result, the patient is subject to medical isolation as prescribed: The health insurance fund does not pay for the Covid-19 testing costs.
• With negative test results: The health insurance fund pays in accordance with the law on medical examination and treatment covered by health insurance:
  • Patients who go for medical services at the right level: Pay according to the beneficiary’s benefit rate and the health care regime that insured at the right level.
  • Patients who go to the wrong level of health care: Pay according to the beneficiary’s benefit rate and the health care regimes that are insured at the wrong level.

Previously, the Ministry of Health issued Official Letter No. 4051 / BYT-KHTC regarding payment for costs related to COVID-19 test, unifying prices of medical examination and treatment services covered by medical insurance among hospitals of the same class across the country and guidelines for applying prices and payment for medical services in certain cases as follows:

• Service No. 1735 of tests for bacteria, viruses, fungi, parasites by Real-time PCR costs 734,000 VND/sample for Real-time PCR method.
• Service No. 1736 of tests bacteria, viruses, fungi, and parasites quickly, at 238,000 VND/sample for quick testing.

References:

1. Official Letter No. 2731/BHXH-CSYT
2. Decree No. 101/2010/ND-CP
3. Decision No. 3351/QD-BYT
4. Official Letter No. 4051/BYT-KHTC