Are students participating in family health insurance in Vietnam required to participate in school health insurance?

Are students participating in family health insurance in Vietnam required to participate in school health insurance?

According to Subsection 1, Section 1 of Joint Guidance 6687/HDLS/BHXH-GDDT 2024 on participants, methods of contributing health insurance:

PARTICIPANTS, CONTRIBUTION RATES, METHODS OF HEALTH INSURANCE CONTRIBUTIONS

1. Participants

Students currently studying at educational institutions within the national education system in Ho Chi Minh City (HCMC), except for those who have joined health insurance under other groups specified by the Law on Health Insurance and foreign students who do not receive scholarships from the Vietnamese government's budget.

Note: For students who have participated in family health insurance, they should switch to student health insurance at the educational institution to get the initial healthcare funding.

2. Student Health Insurance Contribution Rates

The amount for student health insurance = Statutory pay rate (MLCS)*4.5%*70%*number of months participating

Where:

+ MLCS from July 01, 2024, is 2,340,000 VND

+ Number of months participating: 3, 6, 9, 12 months

The specific amount of student health insurance contributions is as follows:

...

Thus, students who have joined family health insurance must switch to school health insurance to receive funding for initial healthcare.

Are students participating in family health insurance in Vietnam required to participate in school health insurance? (Image from the Internet)

What are methods for students in Vietnam to contribute to health insurance?

According to Clause 5, Article 9 of Decree 146/2018/ND-CP, the methods for student health insurance contributions are regulated as follows:

- Periodically every 3 months, 6 months, or 12 months, students or their parents or guardians are responsible for paying the health insurance contribution according to Clause 2, Article 10 of Decree 146/2018/ND-CP to the social insurance agency;

- The state budget supports as follows:

+ Students studying at educational institutions or vocational education institutions under ministries and central agencies are supported by the central budget.

Periodically every 3 months, 6 months, or 12 months, provincial social insurance agencies summarize the number of health insurance cards issued, the amount collected from students, and the amount supported by the state budget according to Form No. 1 of the Appendix issued with Decree 146/2018/ND-CP, sending it to Vietnam Social Security for consolidation, then sending it to the Ministry of Finance to transfer funds into the health insurance fund according to Clause 9, Article 9 of Decree 146/2018/ND-CP.

- Students studying at other educational institutions or vocational education institutions are supported by the local budget, including contributions from the central budget (if any), where the educational institution is situated, regardless of the students' permanent residence.

Periodically every 3 months, 6 months, or 12 months, social insurance agencies summarize the number of health insurance cards issued, the amount collected from students, and the amount supported by the state budget according to Form No. 1 of the Appendix issued with Decree 146/2018/ND-CP, sending it to the financial agency to transfer funds into the health insurance fund according to Clause 9, Article 9 of Decree 146/2018/ND-CP.

What are cases where students are not eligible for health insurance benefits in Vietnam?

According to Article 23 of Law on Health Insurance 2008 (amended by Clause 16, Article 1 of Amended Law on Health Insurance 2014), the cases where students are not eligible for health insurance benefits include:

- Costs for cases specified in Clause 1, Article 21 of Law on Health Insurance 2008 that have been covered by the state budget.

- Convalescence and rehabilitation care at convalescence and rehabilitation facilities.

- Health check-ups.

- Tests and diagnoses of pregnancy not for treatment purposes.

- Use of assisted reproductive technology, family planning services, abortion excluding abortion due to fetal or maternal medical conditions.

- Use of cosmetic services.

- Treatment of squint, myopia and refractive errors of the eyes.

- Use of replacement medical materials, including artificial limbs, artificial eyes, dentures, eyeglasses, hearing aids, and mobility aids during medical examination, treatment, and rehabilitation.

- Medical examination, treatment, rehabilitation in disaster situations.

- Medical examination, treatment for drug addiction, alcoholism, or other addictions.

- Medical examination and forensic, legal psychiatric evaluation.

- Participation in clinical trials, scientific research.