What are household-based health insurance contribution rates in Vietnam for 2024? Who is eligible for household-based health insurance in 2024?

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Household-based health insurance contribution rates in Vietnam for 2024

- Pursuant to Point e, Clause 1, Article 7 Decree 146/2018/ND-CP, the monthly household-based health insurance contribution rates for 2024 are stipulated as follows:

+ The health insurance contribution rates for household participants are as follows: The first person contributes 4.5% of the statutory pay rate; the second, third, and fourth persons contribute 70%, 60%, and 50% respectively of the first person's contribution; from the fifth person onwards, the contribution is 40% of the first person's contribution.

+ The reduction in health insurance contributions as prescribed in this point is executed when household members participate in health insurance together within the financial year.

- According to Clause 2, Article 3 of Decree 24/2023/ND-CP, the current statutory pay rate is 1,800,000 VND/month.

Thus, the household-based health insurance contribution rates for 2024 are as follows:

However, from July 1, 2024, when the salary reform is implemented, the statutory pay rate will be eliminated. Therefore, there may be new guidelines on household-based health insurance contributions starting July 1, 2024.

What are household-based health insurance contribution rates in Vietnam for 2024? Who is eligible for household-based health insurance in 2024? (Image from the Internet)

Who is eligible for household-based health insurance in 2024?

Pursuant to Article 5 of Decree 146/2018/ND-CP, amended by Article 2 of Decree 104/2022/ND-CP, the following individuals are eligible for household-based health insurance in 2024:

- Individuals listed in the same household registration, excluding those specified in Articles 1, 2, 3, 4, and 6 of Decree 146/2018/ND-CP:

+ Group with contributions from employees and employers;

+ Group with contributions from the social insurance agency;

+ Group with contributions from the state budget;

+ Group with state budget support for contributions;

+ Group with contributions from employers.

- Individuals listed in the same household registration residing temporarily, excluding those specified in Articles 1, 2, 3, 4, and 6 of Decree 146/2018/ND-CP and individuals already participating in health insurance as per Clause 1, Article 5 of Decree 146/2018/ND-CP.

The following individuals are eligible for household-based health insurance:

- Religious dignitaries, clergy, and monastics;

- Residents in social protection establishments excluding those specified in Articles 1, 2, 3, 4, and 6 of Decree 146/2018/ND-CP without state budget support for health insurance contributions.

Household-based health insurance benefits in Vietnam for 2024

Pursuant to Article 14 of Decree 146/2018/ND-CP, amended by Clause 1, Article 183 of Decree 131/2021/ND-CP, and Point a, Clause 5, Article 1 of Decree 75/2023/ND-CP, the household-based health insurance benefits are specified as follows:

Health insurance benefits for cases specified in Clauses 1 and 7, Article 22 of the Law on Health Insurance

1. Health insurance participants are entitled to the health insurance fund covering medical examination and treatment costs within the benefit scope at the following rates when visiting and being treated in accordance with Articles 26, 27, and 28 of the Law on Health Insurance; Clauses 4 and 5, Article 22 of the Law on Health Insurance:

a) 100% of medical examination and treatment costs for individuals specified in Clauses 3, 4, 5, 8, 9, 11, and 17 of Article 3 of this Decree;

b) 100% of medical examination and treatment costs without applying payment limits on drugs, chemicals, medical materials, and technical services as prescribed by the Minister of Health for:

- Revolutionary activists before January 1, 1945;

- Revolutionary activists from January 1, 1945, to the August Revolution in 1945;

- Heroic Vietnamese Mothers;

- War invalids, beneficiaries of policies equivalent to war invalids, category B war invalids, and convalescents with a labor decrease from 81% and above;

- War invalids, beneficiaries of policies equivalent to war invalids, category B war invalids, and convalescents when undergoing treatment for recurring injuries or illnesses;

- Individuals involved in resistance activities affected by toxic chemicals with a labor decrease from 81% and above;

- 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 if the costs for one-time medical examination and treatment are less than 15% of the statutory pay rate;

dd) 100% of medical examination and treatment costs if the person has continuously participated in health insurance for five years or more and has paid an amount exceeding six months of statutory pay rate in a year, except when self-seeking medical examination and treatment not in the proper route;

e) 95% of medical examination and treatment costs for individuals specified in Clause 1 of Article 2, Clause 12 of Article 3, and Clauses 1 and 2 of Article 4 of this Decree;

g) 80% of medical examination and treatment costs for other individuals;

h) Patients diagnosed, prescribed treatment, and transferred back for management, monitoring, and medicine provision at the commune-level medical facility according to the Minister of Health's regulations will be covered by the health insurance fund within the entitled scope and benefit rates specified at Points a, b, đ, e, and g, Clause 1 of this Article.

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The household-based health insurance benefits for 2024 are as follows:

- For medical examination at the commune level, the benefit rate is 100%.

- For medical examination and treatment within the proper route but with costs less than 15% of the statutory pay rate, the benefit rate is 100%.

- The benefit rate is 100% of medical examination and treatment costs if the person has continuously participated in health insurance for five years or more and has paid an amount exceeding six months of statutory pay rate in a year, except when self-seeking medical examination and treatment not in the proper route.

- The benefit rate is 80% for medical examination and treatment costs from 15% of the statutory pay rate or more.

Note: From July 1, 2024, when the salary reform is implemented, the statutory pay rate will be eliminated. Therefore, there may be new guidelines on household-based health insurance benefits starting July 1, 2024.