How much is the family-based health insurance contribution rate in Vietnam? Who are the participants in family-based health insurance in Vietnam in 2024?
How much is the family-based health insurance contribution rate in Vietnam in 2024?
- Based on Point e, Clause 1, Article 7 of Decree 146/2018/ND-CP, the monthly family-based health insurance contribution rate in 2024 is prescribed as follows:
+ The health insurance contribution rate of those policyholders defined in Article 5 hereof shall be determined as follows: The first policyholder shall be required to pay 4.5% of the base pay rate; the second, third and fourth policyholder shall be required to pay 70%, 60% and 50%, respectively, of the contribution rate of the first policyholder; the fifth and subsequent policyholder shall be required to pay 40% of the contribution rate of the first policyholder.
+ Any relief or deduction in the health insurance contribution rate as specified in this point shall be granted only if family members participate in the family-based health insurance within the same financial year.
- Pursuant to Clause 2, Article 3 of Decree 24/2023/ND-CP, the current statutory pay rate is VND 1,800,000 /month
Thus, family-based health insurance contribution rate in 2024 include the following:
Household members | Health insurance contribution rate | Family-based health insurance contribution rate in 2024 (Unit: VND/month) | Family-based health insurance contribution rate in 2024 (Unit: VND/month) |
The 1st policyholder | 4.5% of the base pay rate | 81.000 | 972.000 |
The 2nd policyholder | 70% of the contribution rate of the first policyholder | 56.700 | 680.400 |
The 3rd policyholder | 60% of the contribution rate of the first policyholder | 48.600 | 583.200 |
The 4th policyholder | 50% of the contribution rate of the first policyholder | 40.500 | 486.000 |
The 5th and subsequent policyholder | 40% of the contribution rate of the first policyholder | 32.400 | 388.800 |
However, from July 1, 2024, when implementing salary reform, the statutory pay rate will be annulled. Therefore, it is possible that from July 1, 2024, there will be new instructions on family-based health insurance contribution rate.
How much is the family-based health insurance contribution rate in Vietnam? Who are the participants in family-based health insurance in Vietnam in 2024?
Who are the participants in family-based health insurance in Vietnam in 2024?
Pursuant to the provisions of Article 5 of Decree 146/2018/ND-CP amended by Article 2 of Decree 104/2022/ND-CP, group of family-based health insurance policyholders in 2024 include the following:
- Persons whose names are inscribed in the same household registering their permanent residence, except those persons specified in Article 1, 2, 3, 4 and 6 hereof.
- Persons whose names are inscribed in temporary residence records, except those specified in Article 1, 2, 3, 4 and 6 hereof and those already participating in health insurance as prescribed in clause 1 of this Article.
- The following persons eligible for family-based participation in health insurance:
+ Dignitaries, sub-dignitaries and clergy;
+ Persons residing in social relief establishments, except for those defined in Articles 1, 2, 3, 4 and 6 hereof without health insurance contributions supported by the state budget.
What are the regulations on family-based health insurance benefits in Vietnam in 2024?
Pursuant to Article 14 of Decree 146/2018/ND-CP amended by Clause 1, Article 183 of Decree 131/2021/ND-CP, Point a, Clause 5, Article 1 of Decree 75/2023/ND-CP regulating family-based health insurance benefits are as follows:
Health insurance benefits for the cases specified in Clause 1 and Clause 7, Article 22 of the Health Insurance Law
1. Health insurance participants when going for medical examination and treatment according to the provisions of Articles 26, 27 and 28 of the Health Insurance Law; Clauses 4 and 5, Article 22 of the Health Insurance Law, the health insurance fund will pay medical examination and treatment costs within the scope of benefits with the following benefits:
a) 100% of medical examination and treatment costs for subjects specified in Clauses 3, 4, 5, 8, 9, 11 and 17, Article 3 of this Decree;
b) 100% of medical examination and treatment costs and no limit on payment rates for drugs, chemicals, medical supplies and technical services as prescribed by the Minister of Health shall apply to:
- People who participated in revolutionary activities before January 1, 1945;
- Revolutionary activists from January 1, 1945 to the August uprising in 1945;
- Vietnamese heroic Mother;
- Wounded soldiers, policy beneficiaries such as war invalids, class B war invalids, sick soldiers with working capacity reduced by 81% or more;
- War invalids, people receiving policies such as war invalids, class B war invalids, sick soldiers when treating recurring wounds or illnesses;
- Resistance activists infected with toxic chemicals have a working capacity decline rate of 81% or more;
- Children under 6 years old.
c) 100% of medical examination and treatment costs at the commune level;
d) 100% of medical examination and treatment costs in cases where the cost for one medical examination and treatment is less than 15% of the base salary;
d) 100% of medical examination and treatment costs when the patient has participated in health insurance for 5 consecutive years or more and has the amount of money to pay for medical examination and treatment costs in the year greater than 06 months' salary. facility, except for cases where one goes for medical examination or treatment at the wrong level;
e) 95% of medical examination and treatment costs for subjects specified in Clause 1, Article 2, Clause 12, Article 3 and Clauses 1 and 2, Article 4 of this Decree;
g) 80% of medical examination and treatment costs for other subjects;
h) The patient is diagnosed and prescribed treatment by a higher-level medical examination and treatment facility and transferred back to be managed, monitored and dispensed medicine at the commune-level medical examination and treatment facility according to the Minister's regulations. The Ministry of Health is covered by the health insurance fund within the scope of benefits and benefit levels specified in Points a, b, dd, e and g, Clause 1 of this Article.
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Accordingly, family-based health insurance benefits in 2024 will be as follows:
- If medical examination is performed at the commune level, the benefit will be 100%.
- If medical examination and treatment is at the right level but the cost is lower than 15% of the base salary, you will receive 100%.
- The benefit level will be 100% of medical examination and treatment costs when the patient has participated in health insurance for 5 consecutive years or more and has a larger amount of money to pay for medical examination and treatment costs in the year. 06 months base salary, except for cases where you go for medical examination or treatment at the wrong level;
- The benefit level will be 80% if the medical examination and treatment costs are 15% of the base salary or more.
*Note: From July 1, 2024, when implementing salary reform, the base salary will be eliminated. Therefore, it is possible that from July 1, 2024, there will be new instructions on family-based health insurance benefits.
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