Guide to medical examination and treatment procedures with Health Insurance for Referral Visits
University Medical Center Ho Chi Minh City (UMC) is classified at the “Advanced level with high-tech technical capacity” under Decision No. 3949/QĐ-BYT dated December 27, 2024, with a score of 94/100.
To ensure that patients receive their full Health Insurance benefits when receiving medical examination and treatment at UMC, please review the following information and present all required documents correctly and completely.
1. Health Insurance procedures
1.1. a. Health Insurance information
Patients must provide one of the following:
- Health Insurance card;
- Health Insurance card number;
- Citizen Identity Card with integrated Health Insurance information; or
- VNeID account with integrated Health Insurance card information.
For children under 6 years old who have not yet been issued a Health Insurance card:
Present an original or copy of the Birth Certificate, birth registration extract, original or copy of the Certificate of Live Birth, or an Identity Card.
For organ or tissue donors who do not yet have a Health Insurance card:
Present the discharge certificate issued by the healthcare facility where the organ or tissue donation procedure was performed.
For Health Insurance participants who are awaiting the reissuance, replacement, or update of their Health Insurance card/information:
When seeking medical examination or treatment, patients must present the receipt confirming submission of the application and the appointment notice for issuance, reissuance, or replacement of the Health Insurance card/information, issued by the Social Security authority or an organization or individual authorized by the Social Security authority.
1.2. b. Photo identification
For Health Insurance cards without a photograph, patients must present a valid photo identification document, such as:
- Identity Card/Citizen Identity Card;
- Passport;
- VNeID;
- Another identification document issued by a competent authority;
- Identity confirmation issued by the police; or
- Confirmation issued by the educational institution responsible for the student.
This requirement does not apply to children under 6 years old.
1.3. c. Referral documents
For outpatient care under Health Insurance for Referral Visits, patients must present either:
- A valid Health Insurance referral letter or Health Insurance healthcare facility referral form referring the patient to University Medical Center Ho Chi Minh City; or
- A follow-up appointment document for scheduled follow-up visits.
Exception: Patients with rare diseases, serious illnesses, conditions requiring surgery, or conditions requiring high-tech medical services listed in Appendix I of Circular No. 01/TT-BYT may present documentation confirming the relevant condition, such as a prescription or discharge certificate, and do not need a referral document.
2. Health Insurance coverage
2.1. a. Outpatient examination and treatment
| No. | Required documents | Classification | Health Insurance coverage |
| 1 | Health Insurance information; photo identification; referral document or follow-up appointment document | Health Insurance for Referral Visits | 100% of eligible Health Insurance expenses according to the benefit level stated on the card (100% / 95% / 80%) |
| 2 | Health Insurance information; photo identification; documentation confirming a rare disease, serious illness, condition requiring surgery, or condition requiring high-tech medical services under Appendix I of Circular No. 01/TT-BYT | Health Insurance for Referral Visits | 100% of eligible Health Insurance expenses according to the benefit level stated on the card (100% / 95% / 80%) |
2.2. b. Inpatient treatment
| No. | Required documents | Classification | Health Insurance coverage |
|---|---|---|---|
| 1 | Health Insurance information; photo identification; referral document or follow-up appointment document | Health Insurance for Referral Visits | 100% of eligible Health Insurance expenses according to the benefit level stated on the card (100% / 95% / 80%) |
| 2 | Health Insurance information; photo identification | Health Insurance for Non-referral Visits | 100% of eligible Health Insurance expenses according to the benefit level stated on the card (100% / 95% / 80%) |
3. Important notes
- Patients using a referral document for medical examination and treatment must use it within 10 working days from the date of issuance.
- Referral documents for conditions listed in Appendix III of Circular No. 01/TT-BYT are valid for 1 year from the date of issuance, including eligible referral documents issued from 2024 onward.
Attached documents: - Appendix I of Circular 01/TT-BYT
- Appendix II of Circular 01/TT-BYT
- Appendix III of Circular 01/TT-BYT
For further information, please contact the Health Insurance Office of University Medical Center Ho Chi Minh City during office hours at (028) 3952 5372.
Sincerely.