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Vietnam: What does the symbol on the Health Insurance Card indicate about the entitlements for the person undergoing medical examination?

14:59, 11/07/2024

The information on the health insurance card can inform everyone about the beneficiary code and the level of health insurance benefits when going for medical examination and treatment. From December 1, 2018, the beneficiary code and health insurance benefits for some individuals will also change. To know exactly what their benefits are, individuals can refer to this article.

Regarding the subject code (first 2 characters)

The determination of the object code is based on Clause 1, Article 2 of Decision 1351/QD-BHXH on the issuance of the code on the health insurance card.

Example: Code HC is for officials and public employees according to the legal provisions on officials and public employees.

Regarding the benefit level (second box)

- Indicated by number 1: Covered by the health insurance fund 100% of the costs of medical examination and treatment within the scope of health insurance coverage and not subject to the payment percentage limit for certain drugs, chemicals, medical supplies, and technical services as prescribed by the Minister of Health regarding the list, percentage, and conditions for payment of technical services; costs for transporting patients from district level to higher level in case of emergency or during inpatient treatment when needing to transfer for specialized technical intervention.

- Indicated by number 2: Covered by the health insurance fund 100% of costs of medical examination and treatment within the scope of health insurance coverage (subject to the payment percentage limit for certain drugs, chemicals, medical supplies, and technical services as prescribed by the Minister of Health); costs for transporting patients from district level to higher level in case of emergency or during inpatient treatment when needing to transfer for specialized technical intervention.

- Indicated by number 3: Covered by the health insurance fund 95% of costs of medical examination and treatment within the scope of health insurance coverage (subject to the payment percentage limit for certain drugs, chemicals, medical supplies, and technical services as prescribed by the Minister of Health); 100% costs of medical examination and treatment at the commune level and costs for a single costs of medical examination and treatment visit that is less than 15% of the monthly statutory pay rate.

- Indicated by number 4: Covered by the health insurance fund 80% of costs of medical examination and treatment within the scope of health insurance coverage (subject to the payment percentage limit for certain drugs, chemicals, medical supplies, and technical services as prescribed by the Minister of Health); 100% costs of medical examination and treatment at the commune level and costs for a single costs of medical examination and treatment visit that is less than 15% of the monthly statutory pay rate.

- Indicated by number 5: Covered by the health insurance fund 100% of costs of medical examination and treatment, including costs of medical examination and treatment outside the coverage of health insurance; and transportation costs.

Note: According to Official Dispatch 4996/BHXH-CSYT, from December 1, 2018, several subjects will experience changes in their health insurance codes and benefit levels. To be specific:

COMPARISON TABLE OF CHANGES IN SUBJECT CODES AND HEALTH INSURANCE BENEFIT LEVELS FROM DECEMBER 1, 2018

No.	Decree 105		Decree 146		Note
No.	Subject code	Benefit code	Subject code	Benefit code	Note
1	CC	1	CC	1	Supplement object separated from code CK: persons who participated in the revolution exposed to toxic chemicals with labor capacity reduction rate of 81% or more
2	TE	1	TE	1
3	QN	5	QN	5
4	CA	5	CA	5
5	CY	5	CY	5
6	CK	2	CK	2
7	CB	2	CB	2
8	HN	2	HN	2	HN has only 02 objects: people from poor households according to income criteria, people from multidimensional poor households lacking health insurance
9	DT	2	DT	2
10	DK	2	DK	2
11	XD	2	XD	2
12	BT	2	BT	2
13	TS	2	TS	2
14	CT	4	CT	2	Changed benefit code from 4 to 2
15	HT	3	HT	3
16	TC	3	TC	3
17	CN	3	CN	3
18			HK	3	Adding new object code separated from code HN: people from multidimensional poor households not eligible for HN object code
19			ND	4	Adding new object code separated from code HN: people conferred the title of people's artist, excellent artist in households with an average monthly income lower than statutory pay rate
20	DN	4	DN	4
21	HX	4	HX	4
22	CH	4	CH	4
23	NN	4	NN	4
24	TK	4	TK	4
25	HC	4	HC	4
26	XK	4	XK	4
27	TB	4	TB	4
28	TN	4	TN	4
29	NO	4	NO	4	Supplement object: employees during leave period enjoying maternity policy when giving birth or adopting a child
30	XB	4	XB	4
31	CS	4	CS	4
32	XN	4	XN	4
33	MS	4	MS	4
34	HD	4	HD	4
35	TQ	4	TQ	4
36	TA	4	TA	4
37	TY	4	TY	4
38	HG	4	HG	4
39	LS	4	LS	4
40	PV	4	PV	4
41	HS	4	HS	4
42	SV	4	SV	4
43	GB	4	GB	4
44	GD	4	GD	4	People living in social protection institutions excluding those under Articles 1, 2, 3, 4, and 6 of Decree 146, who are not financially supported by the state budget for health insurance premiums.
45	KC	2	KC	4	Changed benefit code from 2 to 4. Supplement object: youth volunteers who received subsidies under Decree 112/2017/ND-CP
46			TH	4	Supplement object: religious dignitaries, clergy members, and monks
47			TV	4	Adding new code: Relatives of workers and public employees in defense serving in the Army.
48			TD	4	Adding new code: Relatives of police employees serving in the Public Security Forces.
49			TU	4	Adding new code: Relatives of people doing other work in cryptographic organizations.

Duy Thinh

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- This translation is generated by OpenAI's GPT-4o model;
- The legal regulations in this article are according to Vietnamese Law;
- This English translation is for reference purposes only and not a definitive translation of the original Vietnamese texts;
- Articles may be compiled from a variety of sources;
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Official Dispatch 4996/BHXH-CSYT

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