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Việc quy định này nhằm khuyến khích người tham gia bảo hiểm y tế đi khám chữa bệnh đúng cơ sở khám chữa bệnh ban đầu, theo tuyến chuyên môn kỹ thuật để hạn chế tình trạng quá tải, hạn chế tuyến trên lạm dụng quỹ khám chữa bệnh của tuyến dưới, đồng thời góp phần phát huy khả năng của cơ sở khám chữa bệnh ban đầu.
Quỹ bảo hiểm y tế sẽ thanh toán 70% chi phí đối với trường hợp khám chữa bệnh tại tuyến huyện, 50% chi phí đối với trường hợp khám chữa bệnh tại tuyến tỉnh, 30% chi phí đối với trường hợp khám chữa bệnh tại tuyến trung ương nhưng không vượt quá 30 tháng lương tối thiểu cho một lần sử dụng dịch vụ kỹ thuật đó.
Về dự thảo Thông tư, đại diện Bộ y tế cho biết sẽ quy định cụ thể hơn, chi tiết hơn, khắc phục những bất cập trong thời gian qua như thẻ bảo hiểm y tế của đối tượng là đồng bào dân tộc thiểu số, người nghèo sẽ gia hạn là 2 năm chứ không làm một năm như trước đây.
Liên quan đến đăng ký khám chữa bệnh ban đầu, Dự thảo Thông tư sẽ quy định thêm vấn đề những đối tượng nào được đăng ký bảo hiểm y tế ở bệnh viện tỉnh,bệnh viên trung ương và các bệnh viện chuyên khoa. Những người sống tại thị xã, nhưng ở đó chỉ có bệnh viện tỉnh thì người này sẽ phải khám ở bệnh viện tỉnh.
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