Guidance on How to Read the Symbols on the New Health Insurance Card Model to Know the Level of Health Insurance Benefits? What is on the Back of the Health Insurance Card?
Guidelines on How to Read Symbols on the New Health Insurance Card to Know the Reimbursement Level?
Based on the regulations in Decision 1666/QD-BHXH in 2020 and Decision 1351/QD-BHXH in 2015, the health insurance card (BHYT) will include symbols indicating the reimbursement level for BHYT participants.
Effective April 1, 2021, the new BHYT card number will only have 10 numerical characters, instead of the previous 15 characters. Besides the BHYT card number, the new BHYT card will print the reimbursement code and the code for the participant’s place of residence.
This code comprises 01 character, numbered from 1 to 5, located at the upper right corner of the front side of the BHYT card, corresponding to the specific reimbursement levels as follows:
- Code number 1: BHYT fund covers:
+ 100% of medical examination and treatment (KCB) costs within the BHYT payment scope and without applying payment limits for certain medications, chemicals, medical supplies, and technical services as stipulated by the Minister of Health regarding the list and payment ratios, conditions for technical service payment;
+ Transportation costs for patients from district-level to higher levels in emergency cases or when transferring for specialized treatment during inpatient care, for beneficiaries marked as: CC, TE.
- Code number 2: BHYT fund covers:
+ 100% of KCB costs within the BHYT payment scope (with payment limits for certain medications, chemicals, medical supplies, and technical services as stipulated by the Minister of Health);
+ Transportation costs for patients from district-level to higher levels in emergency cases or when transferring for specialized treatment during inpatient care, for beneficiaries marked as: CK, CB, KC, HN, DT, DK, XD, BT, TS.
- Code number 3: BHYT fund covers:
+ 95% of KCB costs within the BHYT payment scope (with payment limits for certain medications, chemicals, medical supplies, and technical services as stipulated by the Minister of Health);
+ 100% of KCB costs at the commune level and costs for one KCB session less than 15% of the monthly statutory pay rate, for beneficiaries marked as: HT, TC, CN.
- Code number 4: BHYT fund covers:
+ 80% of KCB costs within the BHYT payment scope (with payment limits for certain medications, chemicals, medical supplies, and technical services as stipulated by the Minister of Health);
+ 100% of KCB costs at the commune level and costs for one KCB session less than 15% of the monthly statutory pay rate, for beneficiaries marked as: DN, HX, CH, NN, TK, HC, XK, TB, NO, CT, XB, TN, CS, XN, MS, HD, TQ, TA, TY, HG, LS, PV, HS, SV, GB, GD.
- Code number 5: BHYT fund covers 100% of KCB costs, including costs outside the BHYT scope; transportation costs, for beneficiaries marked as QN, CA, CY.
If a person belongs to multiple BHYT participant categories, the reimbursement level indicated on the BHYT card will be the highest entitlement level.
Guidelines on How to Read Symbols on the New Health Insurance Card to Know the Reimbursement Level? What is on the Back of the BHYT Card? (Internet Image)
Information Printed on the Card Template and Management Requirements When Issued to Users?
According to Article 3 of Decision 1666/QD-BHXH in 2020, the information printed on the card template and the management requirements when issued to users include:
(1) Management Criteria for BHYT Participants
- Code: print the 10-digit BHXH code of the BHYT participant.
- Full Name: print the full name of the BHYT participant in uppercase letters.
- Date of Birth: print the date, month, and year of birth of the BHYT participant.
- Gender: print male or female according to the BHYT registration file.
- BHYT Reimbursement Code: print (01 character: numbered from 1 to 5) the reimbursement level code of the BHYT participant.
- Code for Place of Residence: print (02 characters: K1/K2/K3) the code for where ethnic minorities and poor family members participating in BHYT reside, living in economically and socially challenging areas, extremely challenging areas, and the code for where BHYT participants live in island communes, island districts.
- Initial Medical Examination and Treatment Registration Location: print the name of the initial medical examination and treatment facility registered by the BHYT participant.
- Validity Period: print the card’s validity period from …/…/…
- Continuous 05-Year Participation: print from …/…/… for those who have continuously participated in BHYT for 05 years according to current regulations, specifically:
+ Those who have continuously participated for 05 years or more as of January 1, 2015, print from January 1, 2015.
+ From January 1, 2015, onwards, those who have not yet or just completed 05 consecutive years should print from the first day of the 6th year.
- Card Issuance and Replacement Location: print the place name of the district and province where the BHXH agency issues or replaces BHYT cards for participants.
- Signature: print the title, scanned signature, and full name of the Head of the Collection and Card Management Department (or the head of the unit under Vietnam Social Security authorized by the Director General of Vietnam Social Security to sign on behalf).
- Photo Position: print a single line black border frame sized 20mm x 30mm for the photo placement.
- Barcode Position: print a two-dimensional barcode (containing the information on the card and the sequence of control characters).
(2) Print Quality: original ink from the manufacturer (do not use overwritten ink) suitable for printers used by BHXH at various levels for printing BHYT cards.
(3) The card is laminated after printing.
What is on the Back of the BHYT Card?
The back of the BHYT card contains 05 points that BHYT participants need to note. Specifically:
- When going for medical examination and treatment, must present the BHYT card with a photo; if no photo, present the BHYT card along with a valid photo ID. Children under 6 years old only need to present the BHYT card.
- Each BHYT participant is issued one card with a unique BHXH code. Use the BHXH code and register for transactions at: https://dichvucong.baohiemxahoi.gov.vn to continue participating in BHYT, replacing, or renewing the BHYT card, and checking the KCB BHYT costs covered.
- To know BHYT card information, access the website: https://baohiemxahoi.gov.vn or text the syntax: BH THE {BHXH code} sent to 8079.
- For any issues, contact the provincial or district BHXH office where the card was issued or call the hotline 19009068 for support and answers.
- The BHYT card must be kept carefully, and not lent to others. In case of loss or damage, promptly notify the BHXH agency.
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