In which cases shall a health insurance card in Vietnam be invalid?
In which cases shall a health insurance card in Vietnam be invalid? - Mr. Van (Lam Dong).
What information is included in the health insurance cards in Vietnam?
Pursuant to Article 12 of the Decree 146/2018/NĐ-CP, health insurance cards shall be issued by competent social insurance agencies and contain the following information:
- Personal information of a policyholder, including full name, gender, date of birth, permanent residence or workplace address.
- Health insurance coverage rate as prescribed.
- Start date of a health insurance card.
- Name of the primary healthcare establishment.
- The consecutive 5-year or longer period of health insurance participation of policyholders making co-payment of healthcare costs. The consecutive period of health insurance participation refers to the date subsequent to the previous date of issue inscribed on a health insurance card; in case of an interval, it must be less than 03 months.
With respect to persons dispatched by competent authorities to go on an educational or business trip; spouses, natural children, or legally adopted children aged under 18 years, accompanying their parents serving terms of office at Vietnam’s overseas missions, their overseas stay period shall be accepted as the period of health insurance participation.
With respect to employees working abroad, the period of their health insurance participation before their overseas work shall be assumed as the period of health insurance participation if they resume participating in the health insurance within duration of 30 days from the date of their entry.
If employees await completion of required procedures for entitlement to unemployment benefits as provided by the Law on Employment, the period of the previous health insurance participation shall be assumed as the period of health insurance participation.
With respect to policyholders, referred to in point a of clause 3 of Article 12 of the Law on Health Insurance, who retire, are demobilized, transfer to other business or resign, if they have not yet participated in the health insurance during the period of their study or military service in the people’s army, the people’s public security force or a cryptographic body, that period shall be assumed as the consecutive period of health insurance participation.
- Photo of the policyholder (not applicable to children under 6 years of age) in case where he/she does not have any photo personal identification document issued by competent bodies or authorities, or any certificate issued by commune-level police authorities or other documents endorsed by educational institutions or vocational education establishments in charge of management of pupils or students, or other legitimate personal identity documents.
In which cases shall a health insurance card in Vietnam be invalid?
Pursuant to Clause 4 Article 16 of the Law on Health Insurance in 2008 stipulating health insurance cards as follows:
Health insurance cards
1. A health insurance card is granted to an insured as a basis for enjoying health insurance benefits under this Law.
2. Everyone may be granted only one health insurance card.
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4. A health insurance card is invalid in the following cases:
a/ Its validity duration expires;
b/ It has been modified or erased;
c/ The card holder no longer joins health insurance.
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As regulations above, a health insurance card is invalid in the following cases:
- Its validity duration expires;
- It has been modified or erased;
- The card holder no longer joins health insurance.
What are cases not eligible for health insurance benefits in Vietnam?
Pursuant to Article 23 of the Law on Health Insurance in 2008 (amended by Clause 16 Article 1 of the Law on amendments to some articles of the Law on Health insurance in 2014) stipulating cases not eligible for health insurance benefits in Vietnam as follows:
- Cases specified in Clause 1 of Article 21 in which costs have been paid by the state budget.
- Convalescence at sanatoria or convalescence establishments.
- Medical check-up.
- Prenatal tests and diagnosis for non-treatment purposes.
- Use of obstetric supportive techniques, family planning services or abortion services, except for cases of discontinuation of pregnancy due to fetal or maternal diseases.
- Use of aesthetic services.
- Treatment of squint, myopia and eye refraction defect except for the children under age 6.
- Use of prostheses including artificial limbs, eyes, teeth, glasses, hearing aids or movement aids in medical examination, treatment and function rehabilitation.
- Medical examination, treatment and functional rehabilitation in case of disasters.
- Medical examination and treatment for addiction to drugs, alcohol or other habit-forming substances.
- Medical assessment, forensic examination, forensic mental examination.
- Participation in clinical trials or scientific research.
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