Hanoi-Vietnam: Rights of pupils and students upon payment of health insurance premiums

- Have the right to register for initial medical examination and treatment covered by health insurance at grassroots-level medical facilities or equivalent, and may change the initial registration at the beginning of each quarter;

- Enjoy 100% of medical if the cost for a single medical examination and treatment is less than 15% of the statutory pay rate;

- Receive 100% of medical costs when the patient has participated in health insurance for 5 consecutive years or more, and the co-payment amount for medical costs in the year exceeds 6 months of the statutory pay rate, except in cases of non-referral medical examination and treatment;

- Receive 80% of medical;- In cases where the health insurance cardholder goes for non-referral medical examination and treatment, the health insurance fund will cover costs according to the following rates:

+ At central-level hospitals: 40% of inpatient treatment costs;-

+ At provincial-level hospitals: 60% of inpatient treatment costs until December 31, 2020, and 100% of inpatient treatment costs from January 1, 2021, nationwide;

+ At district-level hospitals: 70% of medical examination and treatment costs, and from January 1, 2016, 100% of medical examination and treatment costs.

In cases where pupils and students undergo medical examination and treatment at medical facilities that do not have a contract for the provision of medical services covered by health insurance, the costs will be reimbursed at the social insurance agency where they participate, but not exceed the payment rates specified in Appendix 04 of Circular 41/2014/TTLT-BYT-BTC. Specifically:

Legal Basis:

- Law on Health Insurance 2008

- Law on Amendments to law on Health Insurance 2014

- Circular 41/2014/TTLT-BYT-BTC

Why is health insurance mandatory for pupils and students in Vietnam?

Article 34 of the Constitution 2013 stipulates: "Citizens have the right to social security." Article 58 also states that the State and society "implement universal health insurance" and Article 15 provides that "Citizens' rights are inseparable from citizens' duties."

Thus, the Constitution clearly establishes the State's responsibility to ensure social security for the people. Additionally, the people and society also have the responsibility or obligation to participate in social security, specifically in the forms of Social Insurance, Health Insurance, and Unemployment Insurance according to legal regulations.

Clause 1, Article 2 of the Law on Health Insurance states: “Health Insurance is a mandatory form applied to subjects as stipulated by this Law to take care of health, not for profit, organized and implemented by the State.”

Therefore, pupils and students in Vietnam, being Vietnamese citizens and subject to compulsory participation in health insurance as per the law, must naturally have the right and duty to participate in health insurance according to the legal provisions.

(Dr. Bui Sy Loi - Vice Chairman of the National Assembly's Committee on Social Issues)

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