Who are covered by health insurance in Vietnam? What are the current health insurance in Vietnam premiums and payment methods?
Who are eligible for health insurance in Vietnam?
Pursuant to the provisions in Article 17 of the Procedure issued together with Decision No. 595/QD-BHXH in 2017 and Article 1 of Decision No. 505/QD-BHXH in 2020 as follows:
Article 17. Participants in health insurance prescribed in Article 12 of Law on health insurance and its instructional documents
1. Participants whose health insurance premiums are paid by employees and employers shall include:
1.1. The employees who work under indefinite term labor contract, definite term labor contract of full 3 months or more, the employees are the managers of enterprises and cooperatives enjoying salary and working at the agencies, units and organizations specified in Clause 3 of Article 4.2.
1.2. Officials and public employees prescribed by regulations of law on officials and public employees.
1.3. Part-time staffs of communes, wards and townships in accordance with the law on cadres and civil servants.
1.4. The participants whose health insurance are paid by the employees and the police of units and localities:
a/ Citizens who are temporarily recruited before they are officially recruited into the People's Public Security Forces.
b) Public security workers.
c/ Laborers working under labor contracts of indefinite term or labor contracts of a term of full 3 months or more.
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As a result, a person working under an employment contract with an indefinite term shall be eligible for participating in health insurance in Vietnam as prescribed by law.
Who are covered by health insurance in Vietnam? What are the current health insurance in Vietnam premiums and payment methods?
What is the responsibility to pay health insurance in Vietnam premium?
Pursuant to the provisions in Article 18 of the Procedure issued together with the Decision No. 595/QD-BHXH in 2017 amended by Clauses 22, 23 and 24, Article 1 of the Decision No. 505/QD-BHXH in 2020 as follows:
"Article 18. Health insurance premiums payable by the insured prescribed in Article 13 of the Law on Health Insurance and its guiding documents.
1. Health insurance premiums in the cases specified in Point 1.1 and Point 1.2 Clause 1 Article 17 is 4.5% of the monthly salary, 3% of which is paid by the employer, 1.5% by the employee. The monthly salary paid for health insurance premium is the monthly salary paid for compulsory social insurance premium specified in Article 6.
For the subjects specified under Point 1.4, Clause 1, Article 17: the monthly payment rate is equal to 4.5% of monthly salary by scale and title allowances and extra-seniority allowances (for the employees who comply with the salary system stipulated by the State) or 4.5% of monthly salary specified in the labor contract (for the employees who are entitled to salary or wage stipulated by the employers); in which, the police of units and localities shall make 3% payment and the employees shall make 1.5% payment.
2. Health insurance premiums in the cases specified in Point 1.3 Clause 1 Article 17 is 4.5% of the statutory pay rate, 3% of which is paid by the People's Committee of the commune, 1.5% by the employee.
3. Health insurance premiums in the cases specified in Point 2.1 Clause 2 Article 17 is 4.5% of monthly pension or compensation for loss of capacity for work and paid entirely by the social insurance authority.
4. The subjects specified under Points 2.2, 2.3 and 2.5, Clause 2, Article 17: the monthly payment rate is equal to 4.5% of base salary paid by the social insurance agency.
5. Health insurance premiums in the cases specified in Point 2.6 Clause 2 Article 17 is 4.5% of the unemployment benefit and paid entirely by the social security authority.
6. The subjects specified under Point 2.7, Clause 2, Article 17: the monthly payment rate is equal to 4.5% of monthly salary before maternity leave paid by the social insurance agency.
7. The subjects specified under Points 3.1, 3.3a, 3.3b, 3.3c, 3.4, 3.5, 3.6, 3.7, 3.8, 3.9, 3.10, 3.12, 3.13, 3.15 and 3.16, Clause 3, Article 17 and the subjects of households near the poverty line receiving the assistance of 100% of payment rate specified under Point 4.1, Clause 4 of Article 17: the monthly payment rate is 4.5% of base salary paid by the state budget.
8. The subjects specified under Point 3.11, Clause 3, Article 17: the monthly payment rate is equal to 4.5% of base salary paid by the agencies, organizations and units granting the scholarship.
Health insurance premiums in the cases specified in Point 3.14 Clause 3 Article 17 is 4.5% of the monthly salary plus (+) position allowance and seniority pay (if any).
9. The subjects specified under Point 3.2, Clause 3, Article 17: the monthly payment rate is equal to 4.5% of base salary paid by the social insurance agencies from the funds for monthly pension and social insurance allowance guaranteed by the state budget.
10. The subjects specified under Points 4.1, 4.1a, Clause 4 of Article 17: the monthly payment rate is equal to 4.5% of base salary paid by these subjects with the assistance of at least 70% of payment rate from the state budget.
The state budget shall support 100% of health insurance premiums for members of households living just above the poverty line residing in poor districts under the Government's Resolution No. 30a/2008/NQ-CP of December 27, 2008, on the program to support quick and sustainable poverty reduction and districts eligible for mechanisms and policies under Resolution No. 30a/2008/NQ-CP.
11. Health insurance premiums in the cases specified in Point 4.2 Clause 4 Article 17 is 4.5% of the statutory pay rate and paid by the insurance participants.
12. Health insurance premiums in the cases specified in Point 4.3 Clause 4 Article 17 is 4.5% of the statutory pay rate and paid by the insurance participants.
13. The subjects specified in Clause 5, Article 17: the monthly payment rate is equal to 4.5% of base salary paid by these subjects and the payment rate is reduced as follows:
a) The first person pays the premium equal to the prescribed rate.
b) The second, third and fourth persons shall pay by 70%, 60%, 50% of the first person's payment rate.
c) From the fifth person onwards, the payment is equal to 40% of the first person's payment rate;
d) The reduction of health insurance premium in accordance with the provisions of this Point is done when the members participating in health insurance with their family in the same financial year.
14. The subjects specified in Clause 8 of Article 17: the monthly payment rate is equal to 4.5% of base salary paid by the employers from the following sources:
a) State budget shall cover the deficit;
b) For public service providers, their budget shall be used in accordance with regulations of law on autonomy mechanism of public service providers;
c) For enterprises, the funding of enterprises shall be used.
d) Where the subjects in this Clause are simultaneously the subjects participating in different health insurance specified in Clause 1, 2, 3 and 4 of this Decision, the health insurance premium shall be paid in the order as follows: Health insurance premium shall be paid by the employees and employers; by the social insurance agency; paid by the state budget; paid by the employers."
Thus, the level of payment and responsibility to pay health insurance are defined as above.
What is the payment for health insurance in Vietnam?
Based on the provisions in Article 19 of the Procedure issued with Decision No. 595/QD-BHXH amended by Clause 26, 27 and 28, Article 1 of Decision No. 505/QD-BHXH by 2020 on the method of payment of health insurance in Vietnam premium is specified as follows:
"Article 19. Methods of payment of health insurance premiums are specified in Article 15 of the Law on Health Insurance and its guiding documents.
1. The subjects specified in Clause 1 of Article 17: as stipulated in Clause 1, 2 and 3 of Article 7.
2. The subjects specified in Clause 2 and Point 3.2, Clause 3, Article 17: monthly, the social insurance agency shall transfer the health insurance premium from the social insurance fund and unemployment insurance fund to the health insurance fund.
3. The subjects specified under Points 3.1, 3.3b, 3.3c, 3.4, 3.5, 3.7, 3.10, 3.13, 3.15, 3.16, Clause 3 of Article 17 and the subjects wholly supported by the state budget at Point 4.1, Clause 4 of Article 17: On a quarterly basis, the financial agency transfers the health insurance premium to the health insurance fund; no later than 15/12, the subjects must finish the transfer of funds to the health insurance fund of that year.
The subjects specified under Points 3.3a, 3.6, 3.7, 3.8, 3.9, 3.12, Clause 3, Article 17: On a quarterly basis, the agencies of labor, war invalids and social affairs shall transfer the health insurance premium to the health insurance fund no later than the 15th day of December annually.
4. The subjects specified under Point 3.11, Clause 3, Article 17: The agencies or units granting the scholarships shall transfer the health insurance premium to the health insurance fund monthly.
5. The subjects specified under Points 4.1, 4.1a, 4.3, Clause 4 of Article 17: every 03 months, 06 months or 12 months, the representatives of households and individuals shall pay the premium under their responsibility to the collection Agent or make payment at the social insurance agency. In case of failure to participate in the timely manner to enjoy the policies under the approval decision of the competent authority, upon participation, they must participate in the remaining time limit under the decision to enjoy the policies. In case of participation in days in a month, the health insurance premium shall be determined by month from the date of payment of health insurance premium.
6. The subjects specified under Point 4.2, Clause 4, Article 17: every 03, 06 or 12 months, the pupils and students shall make the payment to the schools where they are studying.
7. The subjects specified in Clause 5, Article 17: every 03 months, 06 months or 12 months, the representatives of households shall directly pay the health insurance premium to the social insurance agency or the agent collecting the health insurance premium at communal level.
7a. The subjects specified in Clause 6, Article 17: the employers shall pay the health insurance premium for these subjects together with the payment of health insurance premium for the employees as stipulated.
8. Determination of premiums and assistance with respect to some participants in case of adjustments to the health insurance premium and the statutory pay rate
8.1. For the group of subjects specified in Clause 3, Article 17 and the subjects of households near the poverty line specified under Point 4.1, Clause 4, Article 17 shall be supported 100% by the state budget:
Premiums paid by the state budget shall be determined according to the health insurance premiums and statutory pay rate corresponding to the period specified in health insurance cards. When the State adjusts the payment rate of health insurance premium and the base salary, the amount assisted or paid by the state budget shall be adjusted from the date of application of new payment rate of health insurance premium and new base salary.
8.2. Where the subjects specified in Clause 4 and 5, Article 17 have made one-time payment of health insurance premium for every 03, 06 or 12 months but during this period the State adjusts the base salary, they shall not have to pay the difference under the new base salary."
Thus, the mode of payment of health insurance in Vietnam premium is specified by current law.
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