Which student health insurance card code is eligible for 100% coverage of medical examination and treatment costs?
Students have a big 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 and common illnesses during their studies);
Get medical examination and treatment, rehabilitation, regular pregnancy check-ups, and childbirth;
Medical examination and treatment in cases of suicide and self-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 line;
- Payment for medicines, chemicals, medical supplies, and medical 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);
+ If you have participated in health insurance for 5 consecutive years or more, and have co-paid medical examination and treatment expenses in the year greater than 6 months of basic salary (8,340,000 VND), the Social Insurance agency will issue a certificate of no 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, clinic, 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 district hospital for medical examination and treatment, or are inpatients at provincial or central hospitals: 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 medical examination and treatment without presenting complete documents:paid directly by the Health Insurance Fund at the Social Insurance agency within the scope and level of benefits according to regulations.
In case of medical examination and treatment at a facility without a contract:Payment levels are as follows:
Types of medical examination and treatment | Technical expertise line | Maximum payment for a medical examination and treatment(copper) |
1. Outpatient | District-level medical facilities and equivalent | 60,000 |
2. Boarding | District-level medical facilities and equivalent | 500,000 |
Provincial health facilities and equivalent | 1,200,000 | |
Central and equivalent medical facilities | 3,600,000 |
* Cases not covered by health insurance
- Costs in case of proper medical examination and treatment 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 alternative medical supplies including artificial limbs, artificial eyes, dentures, eyeglasses, hearing aids, and mobility aids in medical examination, treatment, and rehabilitation.
- Medical examination, treatment and rehabilitation in case of disaster.
- Diagnosis and treatment of drug addiction, alcoholism or other addictive substances.
- Medical examination, forensic examination, forensic psychiatric examination.
- Participate in clinical trials and scientific research.
