Vietnam: In 2024, what are the health insurance premiums for participant groups? What are the changes in health insurance premiums from July 1, 2024?
- In 2024, what are the health insurance premiums for participant groups? What are the changes in health insurance premiums from July 1, 2024?
- What are the health insurance benefits applied to persons paying insurance premiums for 5 consecutive years in Vietnam?
- What are the effective dates of health insurance cards in Vietnam?
In 2024, what are the health insurance premiums for participant groups? What are the changes in health insurance premiums from July 1, 2024?
Depending on the different health insurance participant groups, there will be different health insurance premiums in 2024.
The health insurance premium for each participant group is specified as follows:
(1) Health insurance premiums for employees
Employees who work in the formal labor market, have concluded employment contracts, and participate in compulsory social insurance will pay health insurance premiums according to their monthly salary as the basis for social insurance premium payment.
Specifically, in Article 1 of Decree 146/2018/ND-CP, employees in the following cases are required to participate in health insurance:
- Employees working under indefinite-term employment contracts or fixed-term employment contracts, each of which has a term of at least 3 months; managers of enterprises, non-state public service providers, managers or administrators of cooperatives who are entitled to wages or salaries; public officials, servants and employees.
- Part-time officials at communes, wards and townlets by laws.
At Point a, Clause 1, Article 7 of Decree 146/2018/ND-CP, every month, employees working under indefinite-term employment contracts or 3-month employment contracts or more pay 4.5% of their monthly salary to the health insurance fund according to regulations, of which the employer pays 3%, and the employee pays 1.5%.
Therefore, the health insurance premium of these employees shall depend on the monthly salary as the basis for social insurance premium payment, and only changes when the monthly salary as the basis for social insurance premium payment changes.
(2) Health insurance premium for students
According to regulations, the monthly health insurance premium for pupils and students is equal to 4.5% of the statutory pay rate, including 30% funded by the state budget and 70% paid by participants.
The health insurance premium for students is calculated by the statutory pay rate of 1.800.000 VND.
However, on November 10, the National Assembly of Vietnam passed a Resolution on the 2024 state budget estimate. From July 1, 2024, it will implement the overall salary policy reform by Resolution 27-NQ/TW in 2018 of the Seventh Conference of the XII Central Committee of CPV.
Specifically, In Resolution 27-NQ/TW of 2018, from July 1, 2024, the statutory pay rate will be abolished. Thus, upon salary reform from July 1, 2024, health insurance premiums in 2024 will also change.
Currently, there is no official document stipulating the specific health insurance premiums from July 1, 2024.
What are the health insurance benefits applied to persons paying insurance premiums for 5 consecutive years in Vietnam?
In Article 22 of the Law on Health Insurance 2008, amended by Clause 15, Article 1 of the 2014 Law on Amendments to Health Insurance Law, there are regulations on health insurance benefits as follows:
Benefit levels of health insurance
1. The benefit levels of the insured receiving medical examination and treatment in accordance with the regulations in Articles 26, 27 and 28 of this Law whose medical examination and treatment expenditures are covered by the health insurance fund shall be:
a) Total medical examination and treatment expenditures with regard to the insured prescribed in points a, d, e, g, h and i Clause 3 Article 12 of this Law. The costs of the non-covered medical services of the insured prescribed in point a Clause 3 Article 12 of this Law shall be paid by the health insurance budget used for medical examination and treatment of these insured persons; if this budget is insufficient, the State budget shall be in charge.
b) Total medical examination and treatment expenditures with regard to any medical examination and treatment at commune hospitals whose cost is lower than the cost prescribed by the Government.
c) Total medical examination and treatment expenditures with regard to the at least 5-year-insured whose medical examination and treatment expenditures exceed the total amount of statutory pay rate in 6 months, except for the insured who go to the hospitals different from the registered hospitals;
d) 95% of the medial examination and treatment expenditures with regard to the insured prescribed in point a Clause 2, point k Clause 3 and point a Clause 4 Article 12 of this Law;
dd) 80 % of the medial examination and treatment expenditures with regard to other insured persons;
...
Thus, total medical examination and treatment expenditures with regard to the at least 5-year-insured whose medical examination and treatment expenditures exceed the total amount of statutory pay rate in 6 months, except for the insured who go to hospitals different from the registered hospitals shall be covered by the health insurance fund.
Note: the medical examination and treatment expenditures with regard to the insured who go to hospitals different from the registered hospitals shall not be fully covered by the health insurance fund, except for the insured who go to district-level hospitals.
What are the effective dates of health insurance cards in Vietnam?
Under Clause 3, Article 16 of the Law on Health Insurance 2008 amended by Clause 10, Article 1 of the 2014 Law on Amendments to Health Insurance Law, there are regulations on health insurance cards as follows:
Health Insurance Card
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3. The effective dates of the health insurance cards are prescribed as follows:
a) The health insurance cards of the insured prescribed in Clauses 1, 2 and 3 Article 12 of this Law who purchase health insurance for the first time shall be effective from the payment for health insurance;
b) The second health insurance cards and the following ones of the insured who continuously purchase health insurance shall be effective from the expiry of the previous ones.
c) The insurance cards of the insured, prescribed in Clause 4 and Clause 5 Article 12 of this Law who purchase health insurance from the effective date of this Law or discontinuously purchase the health insurance for at least 3 months in the financial year, shall be effective after 30 days from the payment for the health insurance.
d) The insurance cards of the children under age 6 shall be effective until they are full 72 months old. The insurance cards of full-72-month-old child children before their school year begins shall be effective until September 30 in such year.
Accordingly, the effective dates of health insurance cards in Vietnam are specified as follows:
- Health insurance card is valid from the date of payment for health insurance premiums:
+ The group whose insurance are paid by the employers and employees.
+ The group of the insured whose insurance is paid by the social insurance organizations.
+ The group of the insured whose insurance is paid by the State budget.
- The second health insurance cards and the following ones of the insured who continuously purchase health insurance shall be effective from the expiry of the previous ones.
- The insurance cards of the insured who purchase health insurance from January 1, 2015 or discontinuously purchase the health insurance for at least 3 months in the financial year, shall be effective after 30 days from the payment for the health insurance.
+ The group of insured whose insurance is supported by the State budget as prescribed in Clause 4, Article 12 of the Law on Health Insurance 2008.
+ Group of the household insured including household members as prescribed in Clause 5, Article 12 of the Law on Health Insurance 2008.
- The insurance cards of the children under age 6 shall be effective until they are full 72 months old.
The health insurance cards of full-72-month-old child children before their school year begins shall be effective until September 30 in such year.
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