Principles of Health Insurance Regulations: What are the Provisions? What is the Level of Health Insurance Contribution Support from the State Budget?
How are the principles of health insurance regulated?
Pursuant to the provisions of Article 3 of the Law on Health Insurance 2008 (amended by Clause 2, Article 1 of the Law on Amending Health Insurance 2014) as follows:
Principles of health insurance
1. Ensure risk-sharing among health insurance participants.
2. The health insurance contribution level is determined as a percentage of the salary base for mandatory social insurance contributions according to the provisions of the Law on Social Insurance (hereinafter referred to as monthly salary), retirement pension, allowances, or statutory pay rate.
3. Health insurance benefits are determined based on the severity of the illness, the group of subjects within the scope of benefits, and the duration of health insurance participation.
4. The cost of medical examination and treatment under health insurance is co-paid by the health insurance fund and the health insurance participants.
5. The health insurance fund is centrally, uniformly, publicly, and transparently managed, ensuring a balance of revenues and expenditures, and is guaranteed by the state.
Thus, currently, health insurance is implemented according to the principles mentioned above.
How are the principles of health insurance regulated? What is the level of health insurance support from the state budget? (Image from the Internet)
Who is eligible for state-funded health insurance payment support according to regulations?
Pursuant to the provisions of Article 4 of Decree 146/2018/ND-CP amended and supplemented by Clause 2, Article 1 of Decree 75/2023/ND-CP as follows:
Groups eligible for state-funded payment support
1. Individuals from near-poor households according to the near-poor standard period 2022-2025 stipulated in Decree No. 07/2021/ND-CP and other documents issued by the competent authority amending, supplementing, or replacing the near-poor standard applicable for each period.
2. Individuals from multidimensionally poor households not falling under the provisions of Point a, Clause 9, Article 3 of this Decree.
3. Students.
4. Individuals from households engaged in agriculture, forestry, fisheries, and salt production with an average living standard according to the average living standard period 2022-2025 stipulated in Decree No. 07/2021/ND-CP and other documents issued by the competent authority amending, supplementing, or replacing the average living standard applicable for each period.
5. Ethnic minorities residing in areas classified as Zone II, Zone III, and especially difficult villages within ethnic minority and mountainous areas for the period 2016-2020, and these areas are no longer listed in Zone II, Zone III, and especially difficult villages within ethnic minority and mountainous areas for the period 2021-2025 according to the decision of the Prime Minister.
Thus, the individuals eligible for state-funded health insurance payment support include the above-mentioned groups.
Among them:
- The individuals mentioned in Clause 1 and Clause 4 are applicable from October 19, 2023;
- The individuals mentioned in Clause 5 are applicable from November 1, 2023, for 36 months.
What is the level of health insurance payment support from the state budget?
Based on Clause 1 of Article 8 of Decree 146/2018/ND-CP amended and supplemented by Clause 3, Article 1 of Decree 75/2023/ND-CP with the following regulations:
Support level from the state budget
1. From the effective date of this Decree, the support level from the state budget for certain groups is as follows:
a) 100% support for health insurance contributions for individuals from near-poor households residing in poor districts according to the decision of the Prime Minister and other documents issued by the competent authority;
b) At least 70% support for health insurance contributions for individuals specified in Clauses 1, 2, and 5 of Article 4 of this Decree
c) At least 30% support for health insurance contributions for individuals specified in Clauses 3 and 4 of Article 4 of this Decree.
Thus, the level of health insurance payment support from the state budget for the respective groups is as follows:
| No | Group | Support Level || --- | --- | --- || 1 | Individuals from near-poor households residing in poor districts according to the decision of the Prime Minister and other documents issued by the competent authority; | 100% || 2 | - Individuals from near-poor households according to the near-poor standard period 2022-2025 stipulated in Decree No. 07/2021/ND-CP and other documents issued by the competent authority amending, supplementing, or replacing the near-poor standard applicable for each period.
- Individuals from multidimensionally poor households not falling under the provisions of Point a, Clause 9, Article 3 of this Decree.
- Ethnic minorities residing in areas classified as Zone II, Zone III, and especially difficult villages within ethnic minority and mountainous areas for the period 2016-2020, and these areas are no longer listed in Zone II, Zone III, and especially difficult villages within ethnic minority and mountainous areas for the period 2021-2025 according to the decision of the Prime Minister. | 70% || 3 | - Students.
- Individuals from households engaged in agriculture, forestry, fisheries, and salt production with an average living standard according to the average living standard period 2022-2025 stipulated in Decree No. 07/2021/ND-CP and other documents issued by the competent authority amending, supplementing, or replacing the average living standard applicable for each period. | 30% |
Decree 75/2023/ND-CP shall take effect from December 3, 2023.
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