What is health insurance benefit for a person with a serious illness in Vietnam?
Can I ask how much health insurance coverage is for a person with a serious illness? Looking forward to your answer!
Who participates in health insurance in Vietnam?
Pursuant to Article 12 of the 2008 Health Insurance Law amended by Clause 6, Article 1 of the 2014 Amended Health Insurance Law, it stipulates that persons eligible for health insurance are:
Persons eligible for health insurance
1. The group whose insurance are paid by the employers and employees, including:
a) Employees on indefinite or at least full three-month contracts; salaried business managers; officials and civil servants (hereinafter referred to as employees).
b) Part-time officers in communes, wards and towns under the regulations of the law.
2. The group of the insured whose insurance is paid by the social insurance organizations, including:
b) Persons receiving monthly retirement pensions and compensation for loss of capacity for work
b) Persons receiving monthly social insurance pensions due to occupational accidents or diseases or diseases needing long-term treatment; beneficiaries at the age of 80 or above;
c) Officers in communes, wards and towns who have left employment and been receiving monthly social insurance benefits.
d) Persons receiving unemployment benefits.
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Thus, persons eligible for health insurance include:
- Group whose insurance are paid by the employers and employees, including:
+ Employees working under an indefinite-term labor contract or a labor contract with a term of 3 months or more;
+ The employee is a business manager and receives a salary;
+ Officials, civil servants, and public employees (hereinafter collectively referred to as employees);
+ Persons working part-time in communes, wards and towns according to the provisions of law.
- Group paid by social insurance organization , including:
+ People receiving monthly pensions and disability benefits;
+ People who are receiving monthly social insurance benefits due to a work accident, occupational disease or a disease on the list of diseases requiring long-term treatment; people aged 80 or older who are receiving monthly death benefits;
+ Commune, ward, and town officials who have quit their jobs and are receiving monthly social insurance benefits;
+ People receiving unemployment benefits.
- Groups paid for by the state budget include:
+ Officers, professional soldiers, non-commissioned officers, active military soldiers;
+ Professional officers, non-commissioned officers and professional and technical officers and non-commissioned officers working in the people's police force, people's police students, non-commissioned officers and soldiers serving for a limited period of time in the people's police;
+ People who do cipher work are paid the same as soldiers;
+ Cipher students are entitled to benefits and policies according to the regimes and policies for students at military and police schools;
+ Commune, ward and town officials who have quit their jobs and are receiving monthly benefits from the state budget;
+ People who have stopped receiving disability benefits and are receiving monthly benefits from the state budget;
+ People with meritorious services to the revolution, veterans;
+ Current National Assembly deputies and People's Council deputies at all levels;
+ Children under 6 years old;
+ People eligible for monthly social protection benefits;
+ People from poor households;
+ Ethnic minorities living in areas with difficult socio-economic conditions;
+ People living in areas with particularly difficult socio-economic conditions;
+ People living in island communes and island districts;
+ Relatives of people who have contributed to the revolution are the father, mother, spouse, and children of martyrs; people who have contributed to nurturing martyrs;
+ Relatives of people who have contributed to the revolution, except for the following relatives of people who have contributed to the revolution: father, mother, spouse, and children of martyrs; people who have contributed to nurturing martyrs;
+ Relatives of subjects serving in the People's Police and People's Army.
+ People who have donated human organs according to the provisions of law;
+ Foreigners studying in Vietnam are granted scholarships from the Vietnamese State budget.
- Groups whose contributions are supported by the state budget include:
+ People from near-poor households;
+ Pupils and students.
- The group participating in household health insurance includes people belonging to the household, except for the following subjects:
+ Groups are created by employees and employers
+ Group paid by social insurance organization
+ Groups paid for by the state budget
+ Groups are supported by the state budget
What is health insurance benefit for a person with a serious illness in Vietnam? (Image from the Internet)
What is health insurance benefit for a person with a serious illness in Vietnam?
Pursuant to Article 22 of the 2008 Health Insurance Law as amended by Clause 15, Article 1 of the 2014 Amended Health Insurance Law, regulations on benefit levels of health insurance are as follows:
1. The benefit levels of the insured receiving medical examination and treatment in accordance with the regulations in Articles 26, 27 and 28 of this Law whose medical examination and treatment expenditures are covered by the health insurance fund shall be:
a) Total medical examination and treatment expenditures with regard to the insured prescribed in points a, d, e, g, h and i Clause 3 Article 12 of this Law. The costs of the non-covered medical services of the insured prescribed in point a Clause 3 Article 12 of this Law shall be paid by the health insurance budget used for medical examination and treatment of these insured persons; if this budget is insufficient, the State budget shall be in charge.
b) Total medical examination and treatment expenditures with regard to any medical examination and treatment at commune hospitals whose cost is lower than the cost prescribed by the Government.
c) Total medical examination and treatment expenditures with regard to the at least 5-year-insured whose medical examination and treatment expenditures exceed the total amount of the base salaries in 6 months, except for the insured who go to the hospitals different from the registered hospitals;
d) 95% of the medial examination and treatment expenditures with regard to the insured prescribed in point a Clause 2, point k Clause 3 and point a Clause 4 Article 12 of this Law;
dd) 80 % of the medial examination and treatment expenditures with regard to other insured persons;
In what cases are people with serious illnesses referred for treatment in Vietnam?
According to Article 27 of the 2008 Health Insurance Law, treatment-line transfer is prescribed as follows:
Treatment-line transfer
For a case falling beyond the professional and technical capacity of a health insurance-covered medical care provider, such provider may transfer the patient to another provider according to regulations on technical transfer.
Thus, for people with serious illnesses who are referred for treatment in cases that exceed the technical and professional capabilities of a health insurance medical examination and treatment facility, that facility is responsible for promptly transferring the patient to a medical facility. Other medical examination and treatment facilities covered by health insurance according to regulations on professional and technical referrals in Vietnam.
Best regards!
