What are the changes of cost of one-time medical examination and treatment covered by health insurance at 100 % after salary reform in Vietnam?
What are the changes of cost of one-time medical examination and treatment covered by health insurance at 100 % after salary reform in Vietnam?
Pursuant to Resolution 104/2023/QH15 on the state budget estimate for 2024, starting from July 1, 2024, comprehensive salary policy reform will be implemented in accordance with Resolution 27-NQ/TW 2018.
Resolution 27-NQ/TW 2018 has identified the limitations of the current payroll system as follows:
I- SITUATION AND CAUSES
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2. In addition to the achievements, the salary policy still has many limitations and shortcomings. The salary policy in the public sector is complex, and the payroll system is not suitable for job positions and leadership positions. It is too average and does not guarantee a decent living, does not fully utilize talent, and does not create motivation to improve the quality and efficiency of labor. The statutory pay rate multiplied by the coefficient does not reflect the true value of salaries. There are too many allowances and income other than salaries, resulting in inconsistencies and not clearly reflecting the administrative hierarchy in public activities. The rights and responsibilities of the heads of agencies and units in evaluating and paying salaries and bonuses based on labor productivity, quality, and work efficiency of officials, public employees, and employees have not been fully utilized.
Therefore, Resolution 27-NQ/TW in 2018 unified salary reform in 2024 as follows:
Abolish the current statutory pay rate and coefficient and establish a base pay with a specific amount in the new payrolls.
Currently, the statutory pay rate serves as a reference basis for the reimbursement of medical expenses by the health insurance fund..
Specifically, the cost of medical treatment covered 100% by health insurance is based on the statutory pay rate stipulated in Article 14 of Decree 146/2018/ND-CP as follows:
Health insurance policyholders shall be entitled to the health insurance fund’s coverage of permissible medical costs at the following rates:
- 100% of medical expenses for cases where the cost for a single instance of medical treatment is lower than 15% of the statutory pay rate.
- 100% of medical expenses for patients who have participated in health insurance continuously for 5 years or more and have paid an amount of medical expenses in the year exceeding 6 months of the base salary, except for cases where they seek medical treatment outside of the designated healthcare facility.
Therefore, according to the current regulations, for participants in health insurance who are entitled to health insurance benefits with a reimbursement rate of 100% based on the statutory pay rate, the abolition of the statutory pay rate from July 1, 2024, as part of the salary reform according to Resolution 27, will result in changes to the benefits for cases where the cost of a single instance of medical treatment covered 100% by health insurance.
According to information from the Government's electronic portal, this change opens up a new direction where healthcare costs are adjusted to be more in line with the current socio-economic situation. This not only affects the way people access healthcare services but also reflects a significant change in social security policies. This change is expected to bring certain benefits to the people.
What are the changes of cost of one-time medical examination and treatment covered by health insurance at 100 % after salary reform in Vietnam?
What are the regulations on basis for health insurance premium payment in Vietnam?
The basis for health insurance premium payment according to current regulations is salaries, remuneration, and allowances, which are specifically stipulated in Article 14 of the Law on Health Insurance 2008 amended by Clause 8, Article 1 of the Law on amendments to the Law on Health insurance 2014 as follows:
- Employees salaried under state regulations shall pay health insurance premiums based on their monthly salaries paid according to their ranks or grades, and position, extra-seniority or trade seniority allowances (if any).
- Employees salaried or remunerated according to their employers’ regulations shall pay social insurance premiums based on their monthly salaries or remunerations indicated in their labor contracts.
- Persons on monthly pension, working capacity loss allowance or job-loss allowance shall pay health insurance premiums based on their monthly pensions, working capacity loss allowances or job-loss allowances.
- With regard to other insured, their premiums shall be paid according to their statutory pay rate.
- The premiums shall be paid according to the monthly salaries that must not exceed 20 times statutory pay rate
As analyzed above, from July 1, 2024, the statutory pay rate will be abolished when implementing salary reform according to Resolution 27, so the basis for health insurance contributions based on the statutory pay rate will also be changed.
What is health insurance in Vietnam?
Pursuant to the provisions of Clause 1, Article 2 of the Law on Health Insurance 2008 amended and supplemented by Clause 1, Article 1 of the Law on amendments to the Law on Health insurance 2014, Health insurance is a form of compulsory insurance which is implemented by the State to look after the health of the insured according to Law on Health Insurance 2008 (amended in 2014) for non-profit purposes.
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