Ministry of Health Proposes Expansion for Specialized Hospitals and Insurance Coverage

The Ministry of Health has proposed expanding the groups of patients eligible for direct examination at specialized facilities and a 100% health insurance advantage, to include certain children with type 1 diabetes and 22 different disorders in the field of traditional medicine.

New Regulation for Children with Type 1 Diabetes

Patients under 18 years of age who have insulin-dependent diabetes and have developed complications or organ damage will be added to the group that can access specialized health institutions without having to go through referral procedures.

With this regulation, young diabetes patients with complex disorders will have more options regarding direct access to specialized treatment centers and will benefit from 100% health insurance rights.

Changes in Heart Failure Classification

Instead of stage 3 or stage 4 heart failure diagnosis in the current regulation, the condition will be classified as type C and D heart failure in the new draft.

The Ministry of Health stated that this adjustment in criteria aims to review the conditions for accessing specialized facilities during the implementation of the new policy.

22 Diseases in Traditional Medicine and Rehabilitation

In addition to regulating some diseases on the current list, the draft establishes a special separate list for the fields of traditional medicine and rehabilitation.

It is proposed to include 22 diseases and disease types in Appendix IA, and patients will be able to apply directly to specialized traditional medicine hospitals.

Complications After Cancer Treatment

Most of the diseases in this category are related to disorders such as motor sequelae, pain, joint movement restriction, and muscle stiffness that appear after cancer treatment.

Radiotherapy-induced proctitis, cystitis, bowel and bladder dysfunctions, and neurological sequelae are also included in this scope.

Current Status and Expected Advantages

Currently, 62 diseases benefit from direct access to health services, and this revision has been made following the implementation of Circular No. 01/2025.

The elimination of the need for referral procedures will enable patients to access specialized treatment centers earlier after diagnosis, thereby reducing costs.

Effective Date and Expectations

Tran Thi Trang, Director of the Health Insurance Department under the Ministry of Health, stated that this policy facilitates access for patients with serious illnesses, especially cancer patients.

If enacted, the circular amending and supplementing Circular No. 01/2025 is expected to take effect from April 1, 2027.