Which student health insurance card code is eligible for 100% coverage of medical examination and treatment costs?
Students have a great advantage in enjoying health services from the health insurance fund. So what are the specific benefits that this group will enjoy when participating in health insurance?
* Scope of benefits
According to Vietnam Social Security, students receive primary health care at school (first aid, initial treatment for injuries, common illnesses during study time);
Get medical examination and treatment, rehabilitation, regular pregnancy check-ups, and childbirth;
Medical examination and treatment in cases of suicide and self-inflicted injury;
Medical examination and treatment of physical and mental injuries caused by that person's illegal behavior;
- Payment of transportation costs for patients from district level to higher level for students with card codes BT, HN, DT, DK, XD and TS in emergency cases or when being treated as inpatients and having to transfer to a technical specialist level;
- Payment for medicines, chemicals, medical supplies, and medical technical services according to the rates and payment conditions prescribed by the Minister of Health.
* Health insurance benefits
Medical examination and treatment according to prescribed procedures:
- 100% of health insurance medical examination and treatment costs for the following cases:
+ Students with health insurance card codes are: BT, HN, DT, DK, XD, TS.
+ Medical examination and treatment at commune level;
+ Total cost of one medical examination and treatment is lower than 15% of the basic salary (currently 208,500 VND);
+ Having participated in health insurance for 5 consecutive years or more, and having the amount of co-payment for medical examination and treatment costs in the year greater than 6 months of basic salary (8,340,000 VND), the Social Insurance agency will issue a certificate of non-co-payment in the year.
- 95% of medical examination and treatment costs when students have health insurance card codes: TC, CN;
- 80% of medical examination and treatment costs for HS, SV, TA, TQ, TY, TV card codes.
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| Health care benefits paid for by health insurance for students are always guaranteed. |
Students must register for initial medical examination and treatment at the commune health station or district hospital.Health insurance examination and treatment at commune health stations or general clinics or district hospitals in the same province: the benefit level is the same as medical examination and treatment according to prescribed procedures
Students with DT and HN card codes participating in health insurance living in areas with difficult socio-economic conditions, areas with especially difficult socio-economic conditions; students with XD card codes who go to the wrong hospital for medical examination and treatment at the district hospital, or receive inpatient treatment at the provincial or central hospital: the benefit level is the same as prescribed procedures.
Emergency:be examined and treated at any medical facility and receive benefits according to prescribed procedures.
Wrong medical examination and treatment:
- 40% of inpatient treatment costs at central hospitals;
- 60% of inpatient treatment costs at provincial hospitals until December 31, 2020; 100% of inpatient treatment costs from January 1, 2021 onwards nationwide;
- 100% of inpatient and outpatient treatment costs at district hospitals.
In case of going to see a doctor without presenting complete documents:paid directly by the Health Insurance Fund at the Social Insurance agency within the scope and level of benefits as prescribed.
In case of medical examination and treatment at a facility without a contract:Payment levels are as follows:
Type of medical examination and treatment | Technical expertise line | Maximum payment for a medical examination and treatment(copper) |
1. Outpatient | District health facilities and equivalent | 60,000 |
2. Boarding | District health facilities and equivalent | 500,000 |
Provincial and equivalent medical facilities | 1,200,000 | |
Central and equivalent medical facilities | 3,600,000 |
* Cases not covered by health insurance
- Costs in case of medical examination and treatment at the right place but have been paid by the state budget.
- Nursing, convalescence at nursing facilities, convalescence.
- Health check.
- Pregnancy testing and diagnosis are not for treatment purposes.
- Use of assisted reproductive techniques, family planning services, abortion, except in cases where pregnancy must be terminated due to pathological causes of the fetus or the mother.
- Use of cosmetic services.
- Treatment of strabismus, myopia and refractive errors of the eye, except for children under 6 years old.
- Use of replacement medical supplies including artificial limbs, artificial eyes, dentures, eyeglasses, hearing aids, and mobility aids in medical examination, treatment, and rehabilitation.
- Medical examination and treatment, rehabilitation in case of disaster.
- Treatment of drug addiction, alcoholism or other addictive substances.
- Medical examination, forensic examination, forensic psychiatric examination.
- Participate in clinical trials and scientific research.
