Vietnam Social insurance to guide health insurance policies for pupils and students in the 2023-2024 school year

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Vietnam Social Insurance provides guidance on health insurance policies for students in the 2023–2024 school year.

For parents and students to better understand the student health insurance policy in the 2023-2024 school year, Vietnam Social Security provides specific information as follows:

(1) Health insurance payment method and level

When participating in health insurance, students register at the educational institution or school where they are studying. Students can choose to pay health insurance periodically according to 03 methods: 3 months, 6 months, and 12 months. The amount of health insurance participation by students (after deducting the support from the State budget), specifically:

- If students pay every 3 months, the payment rate is: 170,100 VND.

- If students pay every 6 months, the payment rate is: 340,200 VND.

- If students pay every 12 months, the payment rate is: 680,400 VND.

(2) Place of initial medical examination and treatment registration and procedures for medical examination and treatment under health insurance

Students participating in health insurance have the right to register for an initial medical examination at one of the health insurance medical examination and treatment facilities at the commune, district, or equivalent levels according to regulations. Children can choose and change their initial health care registration location at the beginning of each quarter.

When going for a health insurance medical examination, students must present one of the following documents:

- Expired health insurance card or Photo of health insurance card on the VssID application - Digital social insurance and photo identification documents.

Citizen identification card with chip or electronic VneID application that has integrated health insurance card information.

(3) Health insurance benefit level

First, when a student goes for medical treatment at a medical facility that has signed a medical insurance contract:

- In case of a health insurance medical examination at the original registration place and complete procedures for students with a health insurance card benefit code of 4, they will receive 80% of the medical examination costs.

- In case of medical examination and treatment under health insurance at the wrong route: the patient does not have a referral letter but presents complete medical examination procedures under health insurance and will be paid by the health insurance fund within the scope, benefit level, and ratio as prescribed as follows:

- In case the health insurance medical examination does not present complete procedures at the initial medical examination registration place, the social insurance agency will directly pay the health insurance medical examination costs for the following cases:

+ Outpatient medical examination: maximum benefit is not more than 0.15 times the base salary (equivalent to 270,000 VND).

+ Inpatient medical treatment, the maximum benefit is not more than 0.5 times the base salary (equivalent to 900,000 VND).

Second, when a student goes for medical treatment at a medical facility without a medical insurance contract:

The social insurance agency will directly pay health insurance medical examination and treatment costs for the following cases:

- Outpatient medical treatment at district hospitals is entitled to a maximum of 0.15 times the base salary (equivalent to 270,000 VND).

- Inpatient medical care at district hospitals receives a maximum of 0.5 times the base salary (equivalent to 900,000 VND).

- Inpatient medical care at provincial hospitals receives a maximum of 1 time the base salary (equivalent to 1,800,000 VND).

- Inpatient medical care at central hospitals receives a maximum of 2.5 times the base salary (equivalent to 4,500,000 VND).

Third, other special cases are paid directly by the social insurance agency according to the scope of benefits for health insurance participants:

In these cases, specifically:

- Health insurance card data is not provided, or inaccurate health insurance card information is provided.

- The patient cannot present the health insurance card before leaving the hospital, is transferred to the hospital on the same day due to an emergency, loss of consciousness, or death, or has lost the card but has not had it reissued.

- People who have participated in health insurance for 5 consecutive years or more have the amount of co-payment for medical examination and treatment costs during the year greater than 6 months of base salary but have not been paid the co-payment amount of more than 6 months of base salary.

- In case of emergency at a health care facility that does not sign a health insurance health care contract.

Fourth, emergency cases:

Students receive medical treatment at any medical facility and must present their health insurance card and photo identification before leaving the hospital to receive health insurance benefits according to regulations.

(4) Expiry date of health insurance card

First, health insurance cards are issued or renewed annually for students in general education, higher education, and vocational education establishments.

- For grade 1 students: validity for using health insurance cards starts on October 1 of the first year of elementary school.

- For 12th grade students: The card is valid until September 30 of the school year.

- For first-year students of the course: the card is valid from the time of admission, except in the case of a 12th grade student's card that is still valid.

- Final year students of the course: The health insurance card is valid until the last day of the month in which the course ends.

Second, the value of the health insurance card corresponds to the amount of health insurance premium paid according to the number of months the student has participated.

(5) Look up the expiration date of the health insurance card

Students and parents can look up the expiration date of their health insurance cards in the following ways:

- Access the Vietnam Social Insurance Electronic Information Portal at:  https://baohiemxahoi.gov.vn/tracuu/pages/tra-cuu-thoi-han-su-dung-the-bhyt.aspx

- Call the Vietnam Social Insurance Hotline at 1900.9068 for advice and support.

- Install and use the application "VssID - Digital Social Insurance" to track and update health insurance payment and benefit information.

The health insurance policy has truly come to life and is effective in providing comprehensive health care for the young generation. The percentage of students participating in health insurance next year is higher than last year and is approaching the target of 100% coverage.

In the 2022-2023 school year, the country will have about 18.8 million students participating in health insurance, reaching more than 97% of the total number of students.

In the first 8 months of 2023 alone, the whole country had more than 5 million students going for medical examinations under health insurance, which was paid by the health insurance fund with an amount of more than 2,174 billion VND.

Source: Policy development

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