In what cases can people participating in health insurance get their health insurance premiums refunded in Vietnam?

In what cases can people participating in health insurance get their health insurance premiums refunded in Vietnam?

Pursuant to Clause 1, Article 20 Procedures for collection of social insurance contributions and premiums of health insurance, unemployment insurance, occupational accident and occupational disease insurance and issuance of social insurance books and health insurance cards attached to Decision 595/QD-BHXH 2017 regulating the refund of health insurance premiums:

Refund of health insurance premiums

1. A participant prescribed in Clause 4 or 5 Article 17 will have his/her health insurance premium refunded if:

...

In addition, in Clause 4, Clause 5, Article 17 Procedures for collection of social insurance contributions and premiums of health insurance, unemployment insurance, occupational accident and occupational disease insurance and issuance of social insurance books and health insurance cards issued together with Decision 595/QD-BHXH 2017, supplemented by Clause 19, Clause 20, Article 1, Decision 505/QD-BHXH, 2020, amended by Clause 6, Article 2, Decision 490/QD-BHXH, 2023, amended by Clause 1, Article 2, Decision 948/QD-BHXH 2023, regulating subjects participating in social insurance:

Subjects participating in health insurance according to the provisions of Article 12 of the Health Insurance Law and guiding documents, specifically as follows:

...

4. Groups supported by the state budget include:

4.1. People from near-poor households;

4.1a. People in multidimensionally poor households do not fall into the cases specified in Point 3.7, Clause 3 of this Article

4.2. Pupils and students studying at educational institutions under the national education system, including civilian students studying at People's Public Security schools;

4.3. People from households engaged in agriculture, forestry, fishery and salt production have an average standard of living.

5. Group participating in health insurance by household, including:

5.1. People whose names are in the same household register for permanent residence, except for those who fall under the provisions of Clauses 1, 2, 3, 4, 8 of this Article and those who have declared temporary absence.

5.2. People whose names are in the same household registering for temporary residence, except for those specified in Clauses 1, 2, 3, 4, 8 of this Article and those who have participated in health insurance as prescribed in Point 5.1 of this Article

...

Thus, the following subjects will be reimbursed for health insurance in Vietnam including:

- People from multidimensionally poor households

- People from near-poor households;

- Pupils and students studying at educational institutions under the national education system, including civil service students studying at People's Public Security schools;

- People from households engaged in agriculture, forestry, fishery and salt production have an average standard of living.

- Household health insurance participants, except for some subjects as prescribed by law.

In what cases can people participating in health insurance get their health insurance premiums refunded in Vietnam? (Image from the Internet)

In what cases can people participating in health insurance get their health insurance premiums refunded in Vietnam?

Pursuant to Clause 1, Article 20 Procedures for collecting social insurance, health insurance, unemployment insurance, insurance for labor accidents and occupational diseases, management of social insurance books and issued health insurance cards attached to Decision 595/QD-BHXH 2017 regulating refund of health insurance premiums:

Refund of health insurance premiums

1. A participant prescribed in Clause 4 or 5 Article 17 will have his/her health insurance premium refunded if:

1.1. He/she obtains the health insurance card according to the new entity and makes a notification of decrease in validity of the issued card (applying to the participants whose order of payment is subsequent those of the new entity as prescribed in Article 12 of Law on health insurance);

1.2. The state increases the assistance with his/her health insurance premiums;

1.3. He/she dies before his/her health insurance card is valid.

...

Thus, subjects will receive a refund of health insurance premiums in Vietnam in the following cases:

- Participants are issued health insurance cards according to a new group of subjects, but now there is a notice of reduction in the value of the previously issued card.

- The state budget is adjusted to increase support for health insurance premiums

- The health insurance participant dies before the health insurance card is valid.

How much is refund in Vietnam?

Pursuant to Clause 2, Article 20 Procedures for collection of social insurance contributions and premiums of health insurance, unemployment insurance, occupational accident and occupational disease insurance and issuance of social insurance books and health insurance cards attached to Decision 595/QD-BHXH 2017 regulating the refund of health insurance premiums:

Refund of health insurance premiums

...

2. Refunds of health insurance premiums

The refunded premiums shall depend on health insurance premiums and the period in which the premiums have been paid but the health insurance cards have not been used. The period in which the participant has paid premiums but has not used his/her health insurance card shall be counted from:

2.1. The time at which the health insurance card is issued according to the new subject with regard to the participants prescribed in Point 1.1 Clause 1 of this Article.

2.2. The time at which the decision issued by the competent authority comes into force with regard to the participants prescribed in Point 1.2 Clause 1 of this Article.

2.3. The time at which the health insurance card is valid with regard to the participants prescribed in Point 1.3 Clause 1 of this Article.

Thus, the refund amount is calculated based on the health insurance premium and the time the card has been paid but has not been used.

The time the card has been paid but has not been used is calculated from the following time:

- From the moment the health insurance card issued in a new group begins to be valid for participants who are issued a health insurance card in a new group of subjects.

- From the time the competent authority's decision takes effect for subjects whose health insurance premiums are adjusted to increase support from the state budget

- From the time the card is valid for use for subjects who die before the health insurance card is valid for use.

Best regards!