Determine the participants of health insurance with the health insurance card code in Vietnam

According to Decision 1351/QD-BHXH, the health insurance card code includes 15 characters, divided into 04 boxes:

Identification of Health Insurance Participants in Vietnam

Box 1: The first two characters are letters representing the health insurance participant category. If a person belongs to multiple health insurance participant categories, the category code recorded on the health insurance card is that of the first identified category according to the order of the categories.

Group funded by employees and employers:

- DN: Employees working in enterprises established and operating under the Enterprise Law, Investment Law.

- HX: Employees working in cooperatives, cooperative unions established and operating under the Cooperative Law.

- CH: Employees working in state agencies, public service providers, armed forces, political organizations, socio-political organizations, socio-political - professional organizations, socio-professional organizations, and other social organizations.

- NN: Employees working in foreign agencies, organizations, or international organizations in Vietnam (EXCEPT in cases where international treaties to which Vietnam is a party have different provisions).

- TK: Employees working in other organizations that employ workers established and operating under statutory regulations.

- HC: Officials and public employees under statutory regulations on officials and public employees.

- XK: Non-specialized activists at the commune, ward, or commune-level town under statutory regulations on officials;

Group funded by the social insurance organization

- HT: Persons receiving a monthly pension or loss of working capacity allowance;

- TB: Persons receiving a monthly social insurance benefit due to occupational accidents and diseases;

- NO: Employees taking leave to receive sickness benefits under statutory regulations on social insurance due to suffering from diseases on the long-term treatment list prescribed by the Minister of Health;

- CT: Persons aged 80 or older receiving a monthly survivorship allowance;

- XB: Commune, ward, or commune-level town officials who have retired and are receiving monthly social insurance benefits;

- TN: Persons receiving unemployment benefits under the statutory regulations on unemployment insurance;

- CS: Rubber workers who have retired and are receiving a monthly allowance under Decision 206/CP dated May 30, 1979, of the Government of Vietnam regarding policies for new liberation workers in heavy-duty, hazardous occupations who retire due to aging health;

Group funded by the state budget:

- QN: Officers, professional soldiers, non-commissioned officers, soldiers of the Vietnam People's Army on active duty; cryptographic workers receiving salaries like soldiers on active duty at the Government Cryptographic Committee; cryptographic students receiving living expenses from the state budget under policies and regimes applicable to Army students;

- CA: Officers, non-commissioned officers in professional operations and specialized technical fields, non-commissioned officers, enlisted soldiers on active duty in the People's Public Security forces, Public Security students receiving living expenses from the state budget;

- CY: Cryptographic workers receiving salaries like soldiers on duty at cryptographic organizations under ministries, sectors, and localities;

- XN: Commune, ward, commune-level town officials who have retired and are receiving monthly allowances from the state budget;

- MS: Persons who have ceased receiving labor incapacity benefits and are receiving monthly allowances from the state budget;

- CC: Persons with meritorious services to the revolution, including:

- Revolutionary activists before January 1, 1945;

- Revolutionary activists from January 1, 1945, to the August revolution;

- Vietnamese Heroic Mothers;

- War invalids, persons entitled to the same policies as war invalids, category B war invalids, and sick soldiers with a working capacity decrease of 81% or more.

- CK: Persons with meritorious services to the revolution under statutory regulations on those with meritorious services to the revolution, excluding those in the CC category;

- CB: Veterans under statutory regulations on veterans;

- KC: Persons directly participating in the resistance against the US to save the country; Persons participating in the wars to protect the country, performing international duties in Cambodia, helping Laos after April 30, 1975; Youth volunteers during the resistance against the French and youth volunteers who completed their tasks in the resistance; civil defense forces participating in resistance against the French, the US, protecting the country, and performing international duties under the Decisions of the Prime Minister of Vietnam (EXCEPT those in categories CC, CK, and CB);

- HD: Incumbent National Assembly deputies and People's Council deputies at all levels;

- TE: Children under 6 years old, including those who are 72 months old within the calendar year but have not yet entered school;

- BT: Persons receiving monthly social protection allowances under statutory regulations;

- HN: Persons from poor households;

- DT: Ethnic minorities living in economically disadvantaged and particularly difficult areas;

- DK: Persons living in particularly difficult socio-economic areas;

- XD: Persons living on island communes and island districts;

- TS: Relatives of persons who have contributed to the revolution, including parents, spouses, and children of martyrs; persons who have nurtured martyrs;

- TC: Relatives of persons who have contributed to the revolution, including parents, spouses, children over 6 years old and under 18 years old, or from 18 years old and over if they are still in school or have severe disabilities, particularly severe disabilities of the following subjects:

- Revolutionary activists before January 1, 1945;

- Revolutionary activists from January 1, 1945, to the August revolution;

- People's Armed Forces Heroes, Labor Heroes during the resistance period;

- War invalids and sick soldiers with a working capacity decrease of 61% or more;

- Persons involved in the resistance affected by toxic chemicals with a working capacity decrease of 61% or more;

- Biological children over 6 years old of persons involved in the resistance affected by toxic chemicals causing deformities or disabilities due to the chemical's aftermath, unable to perform daily self-care or with reduced self-care capacity (EXCEPT those in category TS).

- TQ: Relatives of the subject receiving QN code;

- TA: Relatives of the subject receiving CA code;

- TY: Relatives of the subject receiving CY code;

- HG: Persons who have donated human organs under the law's regulations;

- LS: Foreigners studying in Vietnam granted scholarships from the Vietnamese state budget;

- PV: Persons serving those with meritorious services to the revolution, including:

- Persons serving Vietnamese Heroic Mothers living at home;

- Persons serving war invalids, and sick soldiers with a working capacity decrease of 81% or more living at home;

- Persons serving those involved in the resistance affected by toxic chemicals with a working capacity decrease of 81% or more living at home.

Group with state budget support for premium payment:

- CN: Persons from near-poor households;

- HS: Students studying at educational and training institutions within the national education system;

- SV: Students studying at educational and training institutions or vocational training facilities within the national education system;

- GB: Persons from households engaged in agriculture, forestry, fishery, and salt production with a medium standard of living as prescribed by statutory regulations;

Group participating in health insurance by household:

- GD: Persons participating in health insurance by household include those in the household, excluding subjects specified at points a, b, c, d above.

Determination of Health Insurance Participation Rates

To determine the benefit level of health insurance participation, refer to Box 2 - the third character from the left (represented by numbers) to know what percentage of health insurance benefits you are entitled to. If a person belongs to multiple health insurance categories, the benefit level recorded on the health insurance card is that of the category with the highest benefit.

Number 1: Fully covered by the health insurance fund (100%) for medical examination and treatment (KCB) costs within the coverage of health insurance and not subject to the payment rate limit for certain medications, chemicals, medical supplies, and technical services as prescribed by the Minister of Health on the list, payment rates, and conditions for technical service payments; transportation costs for patients from district to higher levels in emergency cases or when being transferred for specialized treatment during hospitalization, including those with designations CC, TE.

Number 2: Fully covered by the health insurance fund (100%) for KCB costs within the coverage of health insurance (subject to the payment rate limit for certain medications, chemicals, medical supplies, and technical services as prescribed by the Minister of Health); transportation costs for patients from district to higher levels in emergency cases or when being transferred for specialized treatment during hospitalization, including those with designations CK, CB, KC, HN, DT, DK, XD, BT, TS.

Number 3: 95% covered by the health insurance fund for KCB costs within the coverage of health insurance (subject to the payment rate limit for certain medications, chemicals, medical supplies, and technical services as prescribed by the Minister of Health); Fully covered (100%) for commune-level KCB costs and costs for a single KCB visit lower than 15% of the monthly statutory pay rate, including those with designations HT, TC, CN.

Number 4: 80% covered by the health insurance fund for KCB costs within the coverage of health insurance (subject to the payment rate limit for certain medications, chemicals, medical supplies, and technical services as prescribed by the Minister of Health); Fully covered (100%) for commune-level KCB costs and costs for a single KCB visit lower than 15% of the monthly statutory pay rate, including those with designations DN, HX, CH, NN, TK, HC, XK, TB, NO, CT, XB, TN, XN, MS, HD, TQ, TA, TY, HG, LS, PV, HS, SV, GB, GD.

Number 5: Fully covered by the health insurance fund (100%) for KCB costs, including KCB costs beyond the coverage of health insurance; transportation costs, including those with designations QN, CA, CY.

Identification of Card Issuance Location

Box 3: The next two characters (numbered from 01 to 99) represent the province or centrally-run city code where the health insurance card is issued (according to the province/city codes in Decision 124/2004/QD-TTg dated July 8, 2004, and Official Dispatch 628/TCTK-PPCD dated August 6, 2009, of the General Statistics Office regarding the announcement of the new administrative code list). The Ministry of National Defense's social insurance code is numbered 97, and the People's Public Security's social insurance code is numbered 98.

Identification of Personal Identification Number

Box 4: The last ten characters are the personal identification number of the social insurance and health insurance participant as stipulated in Decision 1263/QD-BHXH dated November 21, 2014, issued by the General Director of Vietnam Social Security on management and use of the shared category system and social insurance reporting indicators.

>> CLICK HERE TO READ THIS ARTICLE IN VIETNAMESE