During sick leave, can I use the health insurance card if my company does not pay insurance contributions?
Regulations on abbreviations in social insurance of Vietnam
Pursuant to Clause 1 Article 2 of Decree 595/QD-BHXH 2017 of Vietnam on term interpretation:
"Article 2: Term interpretation
…
1. Abbreviations
1.1. BHXH stands for the Vietnamese phrase "bảo hiểm xã hội" (social insurance).
1.2. BHTN stands for the Vietnamese phrase "bảo hiểm thất nghiệp" (unemployment insurance).
1.3. BHYT stands for the Vietnamese phrase "bảo hiểm y tế" (health insurance)
1.4. BHTNLĐ, BNN stands for the Vietnamese phrase "bảo hiểm tai nạn lao động, bệnh nghề nghiệp" (occupational accident insurance, occupational disease)
[…]”
What is health insurance?
Pursuant to Clause 1 Article 2 of the Law on Health Insurance 2008 of Vietnam (amended by Clause 1 Article 1 of 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 this Law for non-profit purposes.
Insurance in Vietnam
Cases not eligible for health insurance benefits
Pursuant to Clause 1 Article 23 of the Law on Health Insurance 2008 of Vietnam stipulating cases not eligible for health insurance benefits as follows:
- Cases specified in Clause 1 of Article 21 in which costs have been paid by the state budget.
- Convalescence at sanatoria or convalescence establishments.
- Medical check-up.
- Prenatal tests and diagnosis for non-treatment purposes.
- Use of obstetric supportive techniques, family planning services or abortion services, except for cases of discontinuation of pregnancy due to fetal or maternal diseases.
- Use of aesthetic services.
- Treatment of squint, myopia and eye refraction defect except for the children under age 6. (amended by Clause 16 Article 1 of the Amendments to the Law on Health Insurance 2014 of Vietnam)
- Use of prostheses including artificial limbs, eyes, teeth, glasses, hearing aids or movement aids in medical examination, treatment and function rehabilitation.
- Medical examination, treatment and functional rehabilitation in case of disasters. (amended by Clause 16 Article 1 of the Amendments to the Law on Health Insurance 2014 of Vietnam)
- Medical examination and treatment in case of suicide or self-inflicted injuries.
- Medical examination and treatment for addiction to drugs, alcohol or other habit-forming substances.
- Medical examination and treatment of physical or mental injuries caused by the injured’s law-breaking acts.
- Medical assessment, forensic examination, forensic mental examination.
- Participation in clinical trials or scientific research.
During sick leave, can we use the health insurance card if our company does not pay insurance contributions?
Pursuant to Article 42 of the Law on Health Insurance 2008 of Vietnam stipulating as follows:
“Article 42. Management of participants
1. An employee who signs at least 2 labor contracts with different employers shall pay social insurance contributions and unemployment insurance premiums according to the first labor contract, pay health insurance premiums according to the labor contract with highest salary and pay premiums of occupational accident and occupational disease according to each labor contract.
2. An employee who works under a labor contract (excluding employees working under labor contracts without definite prescribed in the Government's Decree No. 68/2000/ND-CP dated November 17, 2000 on labor contracts for certain jobs in administrative authorities and public service providers) in an administrative authority or a public service provider shall pay insurance contributions or premiums according to his/her salary specified in his/her labor contract.
3. An employer that is allowed to suspend the payment to the retirement and death benefit fund shall still make payment to the sickness and maternity fund, occupational accident and occupational disease fund, health insurance fund and unemployment insurance fund. When the period of suspension from payment of insurance contributions and premiums has expired, the employer shall continue paying insurance contributions and premiums according to the registered payment method and paying premiums for period of suspension from payment to the retirement and death benefit fund. The insurance contributions and premiums in the period of suspension shall not be subject to the late payment interest. Within the period of suspension, if an employee take leave, moves or wishes to receive social insurance benefits, his/her employer shall pay sufficient insurance contributions and premiums and late payment interest (if any) for this employee to confirm his/her social insurance book.
4. An employee who does not work or receive salary for at least 14 working days in a month is not required to pay social insurance contributions in this month. This period shall not be included in the payment period of social insurance contributions.
5. An employee who takes leave due to sickness for at least 14 working days in a month in accordance with regulations of law on social insurance is not required to pay insurance contributions and premiums but still receives benefits from health insurance.
[…]”
Thus, an employee who takes leave due to sickness for at least 14 working days in a month in accordance with regulations of law on social insurance is not required to pay insurance contributions and premiums but still receives benefits from health insurance. Therefore, you can use your health insurance card.
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