Vietnam: According to the Draft Law on Health Insurance dated February 15, 2022, which cases are not covered by health insurance?
- Definition of health insurance according to the Law on Health insurance 2008
- Definition of health insurance according to the Draft Law on Health Insurance dated February 15, 2022
- Principles of health insurance in the Draft Law on Health Insurance dated February 15, 2022
- Which cases are not covered by health insurance?
Definition of health insurance according to the Law on Health insurance 2008
Pursuant to Clause 1 Article 2 of the Law on Health Insurance 2008 of Vietnam (This Clause is amended by Clause 1 Article 1 of the Amendment to the Law on Health Insurance 2014 of Vietnam) stipulating: 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.
Definition of health insurance according to the Draft Law on Health Insurance dated February 15, 2022
Pursuant to Clause 1 Article 2 of the Draft Law on Health Insurance of Vietnam (Draft dated February 15, 2022), the concept of health insurance is as follows:
"Article 2. Interpretation of words
In this Law, the following terms are construed as follows:
1. Health insurance is a form of insurance in health care, not for profit, including:
a) Social health insurance (hereinafter referred to as health insurance for short) is the basic health insurance compulsory for the subjects specified in Article 11 of this Law and organized by the State.
b) Complementary health insurance is a type of voluntary health insurance used by a person participating in health insurance to pay for medical expenses that are outside the coverage of basic health insurance according to the agreements of law in the insurance contract. Complementary health insurance may be provided by a health insurance organization under the Vietnam Social Insurance and accounted for independently of basic health insurance or by insurance enterprises."
Principles of health insurance in the Draft Law on Health Insurance dated February 15, 2022
Article 3 of the Draft Law on Health Insurance of Vietnam (Draft dated February 15, 2022) stipulates the principles of health insurance, specifically:
1. Ensuring risk sharing and social security support in health care among health insurance participants.
2. Health insurance premiums are determined according to the percentage of the salary used as the basis for payment of compulsory health insurance in accordance with the Law on Social Insurance (hereinafter referred to as monthly salary), the amount pension, pension or base salary.
3. Health insurance benefits are based on the degree of illness, the group of subjects within the scope of benefits, the payment level and the duration of health insurance participation.
4. Participants with health insurance can choose the place to go for initial medical examination and treatment at all lawful health care facilities that are eligible for medical examination and treatment with health insurance in close proximity to their places of residence, working and living.
5. Medical examination and treatment expenses covered by health insurance shall be jointly paid by the health insurance fund and the health insurance participants.
6. The health insurance fund is managed centrally, uniformly, openly and transparently, ensuring a balance between revenues and expenditures and is protected by the State.
Which cases are not covered by health insurance?
Which cases are not covered by health insurance?
Cases that are not covered by health insurance specified in Article 28 of the Draft Law on Health Insurance of Vietnam (Draft dated February 15, 2022) are:
1. Expenses in the case specified in Article 24 have been paid by the state budget.
2. Nursing and convalescence at convalescence and convalescence establishments, social care establishments.
3. Use of family planning services; Abortion, convalesce, except the case of termination of pregnancy due to medical causes of the fetus or of the pregnant woman.
5. Use beauty services.
6. Treatment of strabismus, myopia and refractive errors of the eyes, except for children under 18 years old.
7. Medical examination, treatment and rehabilitation in case of disaster.
8. Diagnosis and treatment of addiction to drugs, alcohol and other addictive substances.
9. Medical assessment, forensic examination, forensic psychiatric assessment.
10. Participating in clinical trials and scientific research.
11. Services, drugs, medical supplies, tools and medical equipment that are not on the list, scope and rate of payment promulgated by the Ministry of Health.
Thus, for your case, nose surgery is considered one of the cosmetic services, so the new health insurance does not cover you in the above case.
Best regards!
See details of the Draft Health Insurance Law of Vietnam dated February 15, 2022 here.
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