Who is Eligible for Health Insurance Refunds? Which Cases Qualify for Health Insurance Premium Refunds?
Who Is Eligible for Health Insurance Refund?
Based on Clause 1, Article 20, Collection Procedure for Social Insurance, Health Insurance, Unemployment Insurance, Occupational Accident and Disease Insurance, Social Insurance Book Management, and Health Insurance Card Management issued together with Decision 595/QD-BHXH in 2017 stipulating the refund of health insurance contributions:
Refund of Health Insurance Contributions
1. Individuals currently enrolled in health insurance under the categories specified in Clauses 4 and 5, Article 17, are entitled to a refund of health insurance contributions in the following cases:
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Additionally, in Clauses 4 and 5, Article 17, Collection Procedure for Social Insurance, Health Insurance, Unemployment Insurance, Occupational Accident and Disease Insurance, Social Insurance Book Management, and Health Insurance Card Management issued together with Decision 595/QD-BHXH in 2017 supplemented by Clauses 19 and 20, Article 1, Decision 505/QD-BHXH in 2020 amended by Clause 6, Article 2 Decision 490/QD-BHXH in 2023 further amended by Clause 1, Article 2 Decision 948/QD-BHXH in 2023, the following groups are specified to participate in social insurance:
Participants in Health Insurance as stipulated in Article 12 of the Health Insurance Law and its guiding documents. To be specific:
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4. Groups receiving state budget support for contributions, including:
4.1. Individuals in near-poverty households;
4.1a. Individuals in multi-dimensional poverty households not specified in Point 3.7, Clause 3 of this Article
4.2. Students enrolled at educational institutions in the national education system, including civilian students studying at People’s Public Security schools;
4.3. Individuals in households engaged in agriculture, forestry, fisheries, and salt production with an average living standard.
5. Groups participating in health insurance by household, including:
5.1. Individuals registered as permanent residents in the same household, except those specified in Clauses 1, 2, 3, 4, 8 of this Article, and individuals who have declared temporary absence.
5.2. Individuals registered as temporary residents in the same household, except those specified in Clauses 1, 2, 3, 4, 8 of this Article and individuals who have participated in health insurance as per Point 5.1 of this Article
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Thus, the following groups are eligible for a refund of health insurance contributions:
- Individuals in multi-dimensional poverty households- Individuals in near-poverty households- Students enrolled at educational institutions in the national education system, including civilian students studying at People’s Public Security schools- Individuals in households engaged in agriculture, forestry, fisheries, and salt production with an average living standard- Individuals participating in health insurance by household except for certain groups as stipulated by law
Who Is Eligible for Health Insurance Refund? Which cases qualify for a refund of health insurance contributions? (Image from the Internet)
In Which Cases Is a Refund of Health Insurance Contributions Implemented?
Based on Clause 1, Article 20, Collection Procedure for Social Insurance, Health Insurance, Unemployment Insurance, Occupational Accident and Disease Insurance, Social Insurance Book Management, and Health Insurance Card Management issued together with Decision 595/QD-BHXH in 2017 stipulating the refund of health insurance contributions:
Refund of Health Insurance Contributions
1. Individuals currently enrolled in health insurance under the categories specified in Clauses 4 and 5, Article 17, are entitled to a refund of health insurance contributions in the following cases:
1.1. Participants are issued a health insurance card under a new group, now reporting the reduction in the value of previously issued cards (subordinated to the new group as regulated in Article 12 of the Health Insurance Law);
1.2. The state budget adjusts and increases support for health insurance contributions;
1.3. Participants die before the health insurance card becomes effective.
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Thus, individuals eligible for a refund of health insurance contributions in the following cases:
- Participants issued a health insurance card under a new group, now reporting a reduction in the value of previously issued cards- The state budget adjusts and increases support for health insurance contributions- Participants in health insurance die before the health insurance card becomes effective
How Much of the Health Insurance Contribution Is Refundable?
Based on Clause 2, Article 20, Collection Procedure for Social Insurance, Health Insurance, Unemployment Insurance, Occupational Accident and Disease Insurance, Social Insurance Book Management, and Health Insurance Card Management issued together with Decision 595/QD-BHXH in 2017 stipulating the refund of health insurance contributions:
Refund of Health Insurance Contributions
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2. Refund Amount
The refund amount is calculated based on the health insurance premium and the time period for which contributions were made but the card was not used. The time period for which contributions were made but the card was not used is calculated from the following points:
2.1. From the time the new group health insurance card becomes effective for the participants specified in Point 1.1, Clause 1 of this Article.
2.2. From the time the decision of the competent authority becomes effective for the participants specified in Point 1.2, Clause 1 of this Article.
2.3. From the time the card becomes effective for the participants specified in Point 1.3, Clause 1 of this Article.
Thus, the refund amount is calculated based on the health insurance premium and the time period for which contributions were made but the card was not used.
The time period for which contributions were made but the card was not used is calculated from the following points:
- From the time the new group health insurance card becomes effective for participants issued a health insurance card under a new group- From the time the decision of the competent authority becomes effective for participants whose health insurance contributions were increased by state budget adjustment- From the time the card becomes effective for participants who died before the health insurance card became effective
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