On the health insurance card, there is information "05 consecutive years", so what is the meaning of continuous 5-years health insurance in Vietnam? The following article provides information about continuous 5-year health insurance in Vietnam.
Information about health insurance for 5 consecutive years in Vietnam (Illustration)
1. What is continuous 5-year health insurance in Vietnam?
According to the provisions of Clause 5, Article 12 of Decree 146/2018/ND-CP , the health insurance card reflects the following information:
"Duration of participation in health insurance for 05 consecutive years or more for subjects who have to pay together for medical examination and treatment. The period of continuous social health insurance participation is the period of use stated on the social health insurance card the next time after the previous time; in case of interruption, it shall not exceed 03 months. "
Thus, continuous 5-year health insurance is the case where the participant has participated in continuous health insurance for 5 years or more, if there is any interruption, the maximum duration shall not exceed 03 months.
2. How to get continuous 5-year health insurance in Vietnam?
Conditions for patients to enjoy continuous 5-year health insurance in Vietnam include:
- Have a period of enrollment in Shi for 05 consecutive years or more;
- Having the amount of co-payments for medical examination and treatment in the year is greater than 6 months of base salary (corresponding to VND 8,940,000).
- The co-pay/co-pay amount is the amount that the patient with Shi has to pay with the social insurance agency as a percentage of the health insurance card entitlement.
- Go to medical examination and treatment on the right route.
3. Documents for enjoying continuous 05-year health insurance in Vietnam
According to Notice 2298/TB-BHXH in 2018, the person eligible for payment shall submit to the social insurance agency the following documents to be settled:
- Health insurance card with the text "05 consecutive years: from dd/mm/yy";
- Copy of ID
- Hospital bills (original).
4. Guidance on payment of medical examination and treatment expenses for patients enrolled in Shi for 5 consecutive years in Vietnam
Clause 3, Article 27 of Decree 146/2018/ND-CP guiding the payment of medical examination and treatment expenses for patients who have been enrolled in health insurance for 05 consecutive years or more as follows:
- In case the patient has the same payment amount at one time or more times of medical examination and treatment at the same medical examination and treatment establishment is more than 06 months' base salary, the medical examination and treatment establishment in Vietnam shall not collect the same payment amount of more than 06 months' base salary of the patient.
Medical examination and treatment establishments shall be responsible for providing collection invoices for the amount of 6 months' base salary for patients to have grounds to request social insurance agencies to confirm that they are not required to pay the same amount in that year;
- In case the patient has the same amount of accumulated payment in the financial year at medical examination and treatment establishments in Vietnam or at the same medical examination and treatment establishment for more than 06 months of base salary, the patient shall bring the voucher to the social insurance agency where the health insurance card is issued to pay the same amount of payment for more than 06 months of base salary and receive a certificate of not having to pay in the same year;
- In case the patient has a co-pay amount exceeding 06 months of base salary calculated from January 1, the health insurance fund shall pay 100% of the medical examination and treatment costs within the benefits of the patient from the time the patient participates for 05 consecutive years to the end of December 31 of that year.
Diem My