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Table 1 Overview of the National Health Insurance system in the Lao PDR [18]

From: Financial burden and health-seeking behaviors related to chronic diseases under the National Health Insurance Scheme in Bolikhamxay Province, Lao PDR: a cross-sectional study

Population coverage

All people in the target areas covered by the NHI who are not yet registered in the system.

Eligible members include individuals in the selected provinces’ family books or with a corresponding identification, as well as individuals with a certificate from the village chiefs of the target provinces.

Available facilities

NHI members can use contracted facilities directly. However, when they use other facilities, they require a referral letter from the contracted health facility.

Co-payment

Under the NHI, the payment system for health services has been simplified: healthcare visits require only a small, fixed co-payment at the facility level, regardless of the administered treatment. For instance, outpatients at provincial hospitals (i.e., referral hospitals), district hospitals, and health centers must submit flat co-payments of 15,000 LAK (0.93 USD), 10,000 LAK (0.62 USD), and 5000 LAK (0.31 USD), respectively. For inpatients, the co-payments at both provincial and district hospitals amount to 30,000 LAK (1.87 USD) and 5000 LAK (0.31 USD), respectively, at health centers. The NHI package officially includes a range of services, such as acute and long-term care (including palliative care), and there are no cost limitations.

Service coverage

NHI members (insurers) can use all healthcare services without specific fees at public healthcare facilities, including drug fee, treatment service fee, medical equipment fee, diagnostic fee, document fee, patient room fee, and other medical and non-medical fees.

Funding resources

Government budget, donor support, private

organizations or individuals, and NHI-generated earnings.

  1. NHI National Health Insurance