6 special cases are considered to have continuous participation in health insurance

From December 1, 2018, many health insurance policies come into effect.

According to the Health Insurance Policy Implementation Board (Vietnam Social Security), from December 1, 2018, many policies in favor of health insurance card participants stipulated in Decree 146/2018/ND-CP will take effect.

About health insurance participants

Decree 146/2018/ND-CP adds subjects participating in health insurance, including:

Group funded by the State budget: Conscripted laborers participating in the resistance war against France, against the US, the war to protect the Fatherland and performing international duties as prescribed in Clause 2, Article 4 of Decision No. 49/2015/QD-TTg; Southern grassroots youth volunteers participating in the resistance war in the period 1965-1975; People's artisans, excellent artisans awarded by the State belonging to families with an average monthly income lower than the basic salary.

Cases that do not have to pay health insurance but are still entitled to health insurance benefits:

Employees on sick leave for 14 days or more per month;

Children who are 72 months old but born before September 30 of the year they turn 72 months old;

Children 72 months old born after September 30 but on any day of the month will have their card issued until the end of the month of birth.

Level of support from the State budget:

Near-poor people living in poor districts: 100% support

Multidimensional poor people lacking health insurance: 70% support

Students, people from NLNDN households with average living standards: 30% support.

Groups participating in family health insurance include:Dignitaries, officials, monks; People living in social protection facilities, not subjects belonging to groups 1, 2, 3, 4 as prescribed in the Law on Health Insurance.

Additional group paid by the Employer, including:Relatives of workers, defense officials, police officers and other employees in key organizations serving in the military, police and key agencies.

Adjust the object group

The Decree stipulates that people aged 80 and over who receive monthly pension benefits will be transferred from the group paid by social insurance to the group paid by the State budget according to the provisions of the Law on Social Insurance.

Accordingly, the poor are divided into 2 groups: Poor people based on income criteria, multidimensional poor people lacking health insurance (group 3); People from multidimensional poor households without health insurance shortage (group 4).

About health insurance premium payment and health insurance payment method

For households, Decree 146/2018/ND-CP stipulates that the health insurance premium can only be reduced when all members of the household participate in the same fiscal year.

Subjects who have received State budget support for their contribution level will not be subject to a reduction in contribution level.

In case the subject belongs to group 6 (newly created) and belongs to many different subjects participating in health insurance, health insurance payment shall be made in the following order: by the employee and employer; by the social insurance agency; by the state budget; by the employer.

For groups 4 and 5 participating in health insurance on any day of the month: the health insurance payment amount is determined from the date the health insurance participant pays (not from the beginning of the month of payment).

Adjusting health insurance benefits

For those who participated in the resistance war but were not revolutionary contributors and veterans: Reduced from 100% to 80% in accordance with the provisions of the Law on Health Insurance;

For resistance fighters infected with toxic chemicals with a labor capacity reduction rate of 81% or more: benefit level is 100%, payment rate limit for drugs, chemicals, medical supplies and technical services is applied to 100%, payment rate limit is not applied.

People aged 80 and over who are receiving monthly pension benefits: increase from 80% to 100% to ensure fairness with other social protection beneficiaries over 80 years old.

Some special cases are considered to have continuous health insurance participation.

According to Decree 146/2018/ND-CP, the above special cases include:

- Maximum interruption not exceeding 03 months

- People sent by competent authorities to work, study, work or as spouses or biological or legally adopted children under 18 years old following their parents to work for a term at a Vietnamese agency abroad who have previously participated in health insurance.

- For workers going to work abroad, the time they participated in health insurance before leaving must be within 30 days from the date of entry.

- For employees who are waiting to receive unemployment benefits according to the provisions of the Law on Employment, the time they previously participated in health insurance is counted as the time they participated in health insurance.

- When police, military, and cryptographic personnel retire, are discharged, change careers, or quit their jobs, if the time spent studying or working in the police, military, or cryptographic personnel has not participated in health insurance, the previous period will be counted as the time of participating in health insurance.