How to Resolve the Issue When an Individual Belongs to Multiple Health Insurance Categories?

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Pursuant to Article 12 of the Health Insurance Law 2008 and Clause 6, Article 1 of the Amended Health Insurance Law 2014, the entities participating in health insurance include:

1. Group paid by employees and employers, including:

- Employees working under indefinite-term labor contracts, labor contracts with terms of 3 months or more; employees who are business managers earning salaries; officials and public employees;

- Non-specialist workers at communes, wards, or commune-level towns according to the provisions of the law.

2. Group paid by social insurance organizations, including:

- Retirees receiving monthly pensions and monthly loss of working capacity allowances;

- Persons receiving monthly social insurance allowances due to occupational accidents, occupational diseases, or suffering from diseases on the list of long-term treatment diseases; persons aged 80 years or older receiving monthly survivorship allowances;

- Retired officials from communes, wards, or commune-level towns receiving monthly social insurance allowances;

- Persons receiving unemployment benefits.

3. Group paid by the state budget, including:

- Officers, professional soldiers, non-commissioned officers, enlisted soldiers in active duty; officers, non-commissioned officers working in professional and technical capacities in the people's police force, police students, non-commissioned officers, servicemen serving for a period in the people's police force; individuals working in critical positions receiving salaries equivalent to those of military personnel; critical position students receiving policies equivalent to those of military and police students;

- Retired officials from communes, wards, or commune-level towns receiving monthly allowances from the state budget;

- Persons who no longer receive loss of working capacity allowances but are receiving monthly allowances from the state budget;

- Persons with contributions to the revolution, veterans;

- Incumbent National Assembly deputies, incumbent People's Council deputies at all levels;

- Children under 6 years old;

- Persons entitled to monthly social protection allowances;

- Persons from poor households; ethnic minorities living in areas with difficult socio-economic conditions; persons living in areas with particularly difficult socio-economic conditions; persons living in island communes or island districts;

- Relatives of persons with contributions to the revolution who are biological parents, biological mothers, spouses, or children of martyrs; persons with contributions to nurturing martyrs;

- Relatives of persons with contributions to the revolution, excluding relatives of persons with contributions to the revolution who are biological parents, biological mothers, spouses, or children of martyrs; persons with contributions to nurturing martyrs;

- Relatives of officers, professional soldiers, non-commissioned officers, enlisted soldiers in active duty; officers, non-commissioned officers working in professional and technical capacities in the people's police force, police students, non-commissioned officers, servicemen serving for a period in the people's police force; individuals working in critical positions receiving salaries equivalent to those of military personnel; critical position students receiving policies equivalent to those of military and police students;

- Persons who have donated human body parts according to the provisions of the law;

- Foreigners studying in Vietnam granted scholarships from the budget of the Government of Vietnam.

4. Group receiving state budget assistance for payment, including:

- Persons from near-poor households;

- Pupils, students.

5. Group participating in health insurance based on household, consisting of those who belong to the household, except for the aforementioned entities.

According to Article 13 of the Health Insurance Law 2008, if a person simultaneously belongs to multiple different health insurance participating entities, the health insurance payment will follow the first entity determined according to the order of the aforementioned entities.

Additionally, under Clause 2, Article 22 of the Health Insurance Law 2008, if a person belongs to multiple health insurance participating entities, they will be entitled to health insurance benefits according to the entity with the highest benefits.

Thus, from the above regulations, it can be seen that in the case of a person belonging to multiple health insurance participating entities, they will pay health insurance according to the first entity determined and enjoy health insurance benefits according to the entity with the highest benefits.

Nguyen Trinh

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