Validity of health insurance cards in Vietnam 2023

Validity of health insurance cards in Vietnam 2023 (Internet image)

Regarding this issue, LawNet would like to answer as follows:

1. Validity of health insurance cards in Vietnam 2023

Validity of health insurance cards in Vietnam according to Clauses 2, 3, 4 and 5, Article 47 of Decision 595/QD-BHXH dated April 14, 2014 (amended in Decision 888/QD-BHXH dated July 16, 2018) is as follows: after:

- A health insurance card shall be valid corresponding to the paid health insurance premium. The time of validity of a health insurance card shall be specified as follows:

+ Health insurance cards issued to the participants prescribed in Clauses 1, 2 and 3 Article 17 of Decision 595/QD-BHXH shall be valid from the day on which health insurance premiums are paid, except for the following participants:

++ A health insurance card issued to an employee entitled to unemployment benefits shall be valid from the day on which he/she receives unemployment benefits specified in a decision issued by a competent authority.

++ Health insurance cards issued to ethnic minorities living in the areas whose social-economic conditions are difficult; people living in the areas whose social-economic conditions are extremely difficult and people living in island communes and island shall be valid from January 01 to December 31 of this year.

++ Health insurance cards issued to people in poor households and people in near-poor households whose health insurance premiums are paid totally by the state budget shall be valid from January 01 to December 31 of this year.

If a social insurance authority receives a list of people in poor households or near-poor households enclosed with the decision on approving the list of people in poor households and near-poor households issued by the competent authority after January 01, the health insurance cards shall be valid from the day on which the decision comes into force.

+ Health insurance cards issued to participants prescribed in Clauses 4 and 5 Article 17 of Decision 595/QD-BHXH and participating in health insurance continuously shall be valid from the day on which the health insurance premiums are paid.

If a person participates in health insurance for the first time or participates discontinuously for at least 3 months in a fiscal year, his/her health insurance card shall be valid after 30 days from the day on which he/she pays health insurance premiums.

+ If the participants prescribed in clause 1 Article 17 of Decision 595/QD-BHXH pay health insurance premiums late for at least 30 days, employers shall bear responsibility under the provisions of Article 49 of the amended and supplemented Law on Health Insurance.

- A participant in health insurance is allowed to change the initial medical facility in the beginning of the first month of a quarter.

- An employee entitled to sickness or maternity benefits continues using his/her issued health insurance card and is not required to replace the health insurance.

Regarding an employee takes leave without salary, if his/her employer makes a document on taking leave due to maternity, his/her insurance card shall be valid from the leave month to the expiry date of the issued card.

Example 18: Mrs. A works for and pay insurance contributions and premiums to the company M from July, 2016. In February, Mrs. A applies for taking leave without salary from March, 2017 and is permitted by the company M. The company M makes a notification of leave without salary from March, 2017 by Mrs. A and submits it to social insurance authority.

The social insurance authority reduces the validity of Mrs. A’s health insurance card from March, 2017. In May, 2017, the enterprise M makes a declaration of leave due to maternity from May 01, 2017 by Mrs. A. Mrs. A's health insurance card shall be specified to be valid from May 01, 2017 to the expiry date specified in the issued card.

- An employee who takes long –term leave due to sickness or leaves his/her job for retirement, his/her issued health insurance card shall be valid until the end of the month in which his/her employer makes a notification of decrease.

The social insurance authority, according to a list of decreased participants, shall make a list of people only participating in health insurance using the specimen D03-TS according to participants suffering long-term sickness or participants receiving monthly pensions or social insurance benefits.

A new health insurance card shall be valid from the first day of the month following the month of declaration.

2. Management of data on and validity of health insurance cards in Vietnam

Management of data on and validity of health insurance cards in Vietnam according to Clause 1, Article 47 of Decision 595/QD-BHXH dated April 14, 2014 is as follows:

Data on health insurance cards shall be managed and connected with data on collection of insurance contributions and premiums. Medical facilities receiving health insurance cards from the sick shall search for information on health insurance card on the portal of information on assessment of health insurance cards to determine use value of the insurance premium cards.

According to search results, medical facilities shall:

- Pay costs of medical examination and treatment under health insurance regarding a participants who is paying health insurance premium and his/her health insurance cards are still valid.

- Not pay costs of medical examination and treatment under health insurance regarding a participant who has made a notification of decrease in the payment of health insurance premiums but his/her health insurance cards are still valid.

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