What you should know about the regulations on the use of health insurance card in Vietnam

What you should know about the regulations on the use of health insurance card in Vietnam (Illustration)

Subjects participating in health insurance

Article 12 of the Law on Health Insurance 2008, amended in 2014, and Decree 146/2018/ND-CP clearly stipulate 06 groups of subjects participating in health insurance:

- Group of health insurance policyholders whose contributions are paid by both employees and employers

- Group of the insured whose insurance is paid by the social insurance organizations

- Group of the insured whose insurance is paid by the State budget of Vietnam

- Group of the insured whose insurance are supported by the State budge

- Group of the household insured including household members

- Other groups of subjects specified by the Government of Vietnam

Expiry date of health insurance card

The use value of the health insurance card is determined based on each type of health insurance card corresponding to each object.

In Clause 3, Article 16 of the Law on Health Insurance 2008, amended in 2014 and Article 13 of Decree 146/2018/ND-CP, the validity period of the health insurance card is as follows:

- The health insurance card is valid from the date of payment of health insurance for the following groups of subjects: groups paid by employees and employers; groups sponsored by social organizations; and the group that is paid by the state budget and participates in health insurance for the first time.

- The health insurance card is valid for use after 30 days from the date of payment of health insurance for the following groups of subjects: groups that receive payment assistance from the state budget; groups participating in health insurance according to households that participate in health insurance from the effective date of this law or participate intermittently for 3 months or more in a fiscal year;

- The health insurance card is valid until the child reaches 72 months of age for children under 6 years of age. If the child is 72 months old and has not yet entered the school year, the health insurance card is valid until September 30 of that year.

- The health insurance card is valid for use immediately after organ donation for the organ donor.

- For groups of students, students:

+ Students at general education institutions receive health insurance cards once a year, which include:

• For 1st grade students, the validity period begins on October 1st of the first year of primary school.
• For 12th grade students, the card is valid until the end of September 30th of that year.

+ Health insurance cards are issued annually to pupils and students of higher education institutions and vocational education institutions, in which:

• For students, first-year students of the course: The card is valid from the date of admission, unless the card of the 12th grade student is still valid.
• For students, final year students of the course: The card is valid until the last day of the month, ending the course.

Note:

• For the group of people who are receiving unemployment benefits, the health insurance card is valid from the first month of receiving unemployment benefits stated in the decision on unemployment benefit enjoyment of the competent state agency.
• For the group of children under 6 years old: In the case of children born before September 30: The health insurance card is valid until the end of September 30th of the year the child is fully 72 months old; Children born after September 30: The health insurance card is valid until the end of the last day of the month the child is fully 72 months old.
• For persons eligible for monthly social protection allowance according to the provisions of the law on the elderly, disabled people, and social protection beneficiaries: the health insurance card is valid from the date of social allowance entitlement at the decision of the district-level People's Committee.
• For those who participate in continuous health insurance from the second time onwards, the health insurance card is valid for consecutive use with the expiry date of the previous card.
• The use value of the health insurance card will correspond to the prescribed health insurance premium, except for children under 6 years old.

03 cases where the health insurance card is not valid

Clause 4, Article 16 of Vietnam's Law on Health Insurance stipulates cases where the health insurance card is not valid:

• Its validity duration expires;
• It has been modified or erased;
• The card holder no longer joins health insurance.

Thus, if an individual erases or modifies information on his/her health insurance card or does not continue to participate in health insurance, the health insurance fund will not pay the cost of medical examination and treatment.

From June 1, 2021, medical examinations and treatments will not require a physical health insurance card in Vietnam.

Thus, from June 1, 2021, patients with health insurance who come for medical examination and treatment can use the image of their health insurance card on the Vss-ID application instead of using a physical health insurance card.

Specifically, users must create an account by downloading the VssID application installed on the smartphone. After creating an account with the owner's photo, users can look up information about their health insurance card, which facility to visit, the process of participating in social insurance, sickness, maternity, and occupational disease regimes. 

Medical examination and treatment facilities use readers to scan the QR code. If there is no reader, write the health insurance card number directly on the VssID application.

In particular, it should be noted that for users who do not have an account on VssID, they can still receive medical examination and treatment with a paper health insurance card according to Clause 1, Article 28 of the Law on Health Insurance 2008.

Bao Ngoc

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