Can a birth certificate be used for medical examination when a child is not awarded health insurance cards in Vietnam?

Can a birth certificate be used for medical examination when a child is not awarded health insurance cards in Vietnam?

Pursuant to Article 15 of Decree 146/2018/ND-CP stipulating procedures for insurance covered healthcare services, as follows:

1. When visiting healthcare establishments for medical examination or treatment services, health insurance policyholders must present photo health insurance cards; in case of absence of the photo, they shall be required to present one of their photo identity documents issued by competent bodies or authorities, or certificates endorsed by commune-level police authorities or others endorsed by educational institutions in charge of management of pupils or students; other legitimate personal identification documents.

2. When children under 6 years of age go to healthcare establishments to receive medical examination or treatment services, only health insurance cards shall be needed. If a child is not awarded health insurance cards, a copy of the written evidence of birth or a copy of the birth certificate must be shown; in case where such child needs medical treatment after birth but he/she is not awarded the written evidence of birth, the head of the healthcare establishment, parents or guardian of that child shall be required to sign in the medical record as a basis for payment of health insurance benefits as prescribed in clause 1 of Article 27 hereof and shall bear responsibility for their endorsement.

3. When visiting healthcare establishments to receive medical examination or treatment services, a health insurance policyholder who is expecting a new health insurance card which is reissued or replaces the preexisting one must present the note of appointment for reissuance and replacement of health insurance card issued by the social insurance agency or any entity or individual authorized by the social insurance agency to receive applications for reissuance and replacement of health insurance cards by using the Form No. 4 of the Appendix to this Decree, and any document evidencing personal identity of that policyholder.

4. When a health insurance policyholder who has donated his/her organ visits healthcare establishments to receive medical examination or treatment services, he/she must present documents referred to in clause 1 or clause 3 of this Article. In case where the medical treatment is needed immediately after the organ donation, the head of the healthcare establishment performing organ procurement and the patient or the patient's relative must bear their signature on the medical record as a basis for payment of health insurance benefits in accordance with clause 2 of Article 27 hereof, and shall be responsible for their endorsement.

5. In case of a referral to another healthcare establishment at the different level, a policyholder shall be required to present his/her referral dossier formulated by the referring healthcare establishment and the referral form by using the Form No. 6 of the Appendix to this Decree. In case where the referral form is valid until the end of December 31 while the medical treatment has not yet been completed, use of that referral form till the end of that medical treatment shall be allowed.

In case of a follow-up examination, a health insurance policyholder must show the note of follow-up appointment of the healthcare establishment which is prepared by using the Form No. 5 of the Appendix to this Decree.

6. In case the emergency treatment service is needed, a health insurance policy may choose to be hospitalized at any healthcare establishment and shall be required to present documents referred to in clause 1, clause 2 or clause 3 of this Article before discharge from that healthcare establishment. After the emergency treatment stage, if the insured patient is allowed by the healthcare establishment to implement procedures for referral to another ward or department of that healthcare establishment in order for them to receive further health monitoring and treatment, or to be referred to another healthcare establishment, these referrals shall be defined as appropriate-level referrals.

The healthcare establishment that does not enter into the health insurance-covered healthcare service contract shall be responsible for providing patients allowed for hospital discharge with valid documents and evidences relating to medical costs which they use for directly claiming payments of their health insurance benefits at social insurance agencies under the provisions of Article 28, 29 and 30 hereof.

7. If a health insurance policyholder takes up a temporary residence while going on a business trip, working on the move or taking a full-time training program, he/she shall be entitled to receive primary health care at an appropriate-level healthcare establishment or the healthcare establishment at the level equivalent to the healthcare establishment providing primary care which is inscribed on his/her health insurance card, and shall be required to present documents stipulated in clause 1, clause 2 or clause 3 of this Article and one of the following documents (either in the form of an authentic copy or a duplicate): business travel form, decision to send personnel to participate in a training course, student identity card, temporary residence evidencing document and school transfer approval form.

8. Healthcare establishments and social insurance agencies shall not be allowed to adopt supplemental procedures for health insurance-covered services in addition to those procedures stipulated in this Article. In case where healthcare establishments or social insurance agencies need copies of the health insurance card and other documents relating to medical examination and treatment of patients to serve administrative tasks, they shall be required to make copies at their expense and shall not be allowed to request patients to make copies or pay photocopy costs.

Thus, when your child has not been issued a health insurance card, when going to medical examination and treatment, you can present a copy of the written evidence of birth or a copy of the birth certificate for medical examination and treatment in Vietnam.

What is application for first-time health insurance-covered service contract in Vietnam?

Pursuant to Article 16 of Decree 146/2018/ND-CP stipulating health insurance-covered service contracts:

1. In case of a first-time health insurance-covered service contract, documents shall include:

a) Request form for signing the contract, prepared by the requesting healthcare establishment;

b) Duplicate of the healthcare license, issued by a competent regulatory authority to the requesting healthcare establishment;

c) Internally stamped duplicate of the decision on ranking of hospitals made by a competent regulatory authority (if any) or the decision on medical level issued by a competent regulatory authority with respect to non-public healthcare establishments;

d) List of medical technology services, medicines, chemicals or medical supplies, approved by a competent regulatory authority (whether in the written or electronic form).

2. In case where a healthcare establishment obtains a competent regulatory authority’s approval of supplementation of functions, duties, scope of professional practices and hospital ranking, that healthcare establishment shall be responsible for informing a competent social insurance agency of adding the abovementioned information to the health insurance-covered service contract. Within duration of 10 working days of receipt of the written document stating approval from the healthcare establishment, the receiving social insurance agency shall be responsible for completely signing on appendices to the contract or entering into a new contract.

According to this Article, when performing first-time health insurance-covered service contract, the application for first-time health insurance-covered service contract includes the following contents in Vietnam.

Best Regards!