Determination of Health Insurance Benefits According to the New Statutory Pay Rate

Kim Linh

21:34, 10/07/2024

Vietnam Social Security has just issued Official Dispatch 1602/BHXH-CSYT applying the statutory pay rate according to Decree 38/2019/ND-CP in the payment of medical examination and treatment costs covered by health insurance.

The level of health insurance benefits as stipulated in Clause 1, Article 14 of Decree 146/2018-ND-CP is specifically determined as follows:

- 15% statutory pay rate equivalent to 223,500 VND;- 6-month statutory pay rate equivalent to 8,490,000 VND.

Meanwhile, direct payment rates for medical examination and treatment cases at medical facilities without a health insurance contract as stipulated in Article 30 of Decree 146/2018-ND-CP are implemented as follows:

- 0.15 times the statutory pay rate equivalent to 223,500 VND;- 0.5 times the statutory pay rate equivalent to 745,000 VND;- 1.0 times the statutory pay rate equivalent to 1,490,000 VND;- 2.5 times the statutory pay rate equivalent to 3,725,000 VND.

The payment rate for medical supplies costs as stipulated in Point b, Clause 2, Article 3 of Circular 04/2017/TT-BYT does not exceed 45 months of the statutory pay rate equivalent to 67,050,000 VND.

For details, refer to Official Dispatch 1602/BHXH-CSYT issued on May 16, 2019.

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