The Ministry of Health has just issued Circular No. 01/2025/TT-BYT which is effective from January 1, 2025 on the implementation of a number of articles of the Law on Health Insurance. According to the new Circular, insured patients with rare and serious diseases are not required to have referral papers to large medical examination and treatment facilities in big cities.
Taking a bus to Ho Chi Minh City at 3 a.m., a 41 year old woman named Nguyen Thi Ha in Dong Nai Province took her father with colon cancer to Ho Chi Minh City Oncology Hospital’s second branch for examination.
According to Ms. Ha, a referral paper is very time-consuming, sometimes taking a whole day of waiting, so elderly patients are very tired. Therefore, her father immediately agreed to go to Ho Chi Minh City for specialized treatment after he was told that insured patients with serious diseases do not need a referral paper.
However, she was told by a medical staff of Ho Chi Minh City Oncology Hospital’s second branch that colon cancer still needs a referral from the provincial hospital to be eligible for full health insurance. Because they arrived at the hospital, she was willing to pay for his father’s examination, but her father was afraid of spending money, so he returned to his hometown and waited to complete the procedures later, Ms. Ha said disappointedly.
A man from Long An Province also fell into a similar situation because he misunderstood the regulations when taking his family member to the hospital for stomach cancer examination.
When the new regulations on referral papers under the Ministry of Health’s Circular No. 01/2025/TT-BYT (Circular 01) on the implementation of a number of articles of the Law on Health Insurance officially took effect from January 1, 2025, many cancer patients thought that cancer was a serious illness and therefore did not need a referral paper.
However, according to regulations, the exemption from referral papers when going to a specialized hospital only applies to the list of 62 rare diseases, serious diseases, diseases requiring surgery or using high technology issued by the Ministry of Health.
This list includes many serious diseases, such as dangerous infectious and parasitic diseases including tuberculous meningitis, tuberculous meningitis, fungal infections of the lungs, malignant tumors (in the pancreas, thymus, heart, mediastinum, meninges, lymphatic system, hematopoietic system), diabetes with multiple complications, some metabolic disorders, some congenital malformations, lupus erythematosus, organ transplants, heart valve replacement surgery, Alzheimer's disease, dementia and permanent disability.
According to Dr. Diep Bao Tuan, Director of Ho Chi Minh City Oncology Hospital, the new regulations in the Ministry of Health’s Circular have facilitated patients’ participation in health insurance, reduction of travel costs and shortening waiting time. On the first day of implementing Circular 01, the hospital received more than 800 insured patients. Moreover, nearly 50 people with of 62 rare and serious diseases were enjoying their benefits from health insurance.
However, the Director of Ho Chi Minh City Oncology Hospital also commented that identifying the right patients in the list of 62 rare and serious diseases also takes more time than before. In addition, it is forecasted that in the coming time, the number of patients may increase as patients from other provinces will come to the hospital for examination and treatment.
Meanwhile, HCMC-located Cho Ray Hospital has arranged staff to directly consult at the reception desks about the procedures for referral papers for the convenience of patients. The hospital's fanpage also updates details of diseases that do not require referral papers, answering patients' questions. In addition, patients can call the hospital's switchboard for advice on referral papers before visiting to avoid wasting time and effort.
Deputy Director Nguyen Thi Thu Hang of Ho Chi Minh City Social Insurance said that Circular 01 which is consistent with the new regulations of the Law on Medical Examination and Treatment and the amended and supplemented Law on Health Insurance has helped improve the quality of health insurance examination and treatment. Patients need to know the hospital that they will go to for examination and treatment provide basic or specialized medical treatment. Last but not least, they must understand which types of diseases are exempt from referral papers to ensure their health insurance benefits.
