1. For persons whose health care insurance premiums are covered by the state budget

1.1 Step 1:

a/ The buyer registers the primary medical examination and treatment establishment with the commune-level People’s Committee. A person who has donated parts of his/her body submits the hospital discharge paper and registers the primary medical examination and treatment establishment with the social insurance agency. 

b/ The commune-level People’s Committee:

- Based on Form DK01; the list of the increased and decreased number of persons whose health insurance premiums are covered by the state budget provided by the health insurance buyer managing agency and the registration of primary medical examination and treatment establishments of the buyers; makes a list of health insurance buyers (Form DK05) and sends it to the social insurance agency.

- Transfers the list and electronic data (if any) to the social insurance agency.

- Receives Form DK05 of persons who have donated parts of their bodies (if any) from the social insurance agency for certification and sends it back to the social insurance agency.

1.2. Step 2:

a/ The social insurance agency:

- The single-window division receives Form DK05 and electronic data (if any) from the commune-level People’s Committee; checks the components and number of sets of the dossier and if the list is correct and complete, hands the appointment slip and then transfers it to the dossier management division/team. If the list is incorrect and incomplete, clearly states the reason and sends it back to the commune-level People’s Committee.
- The dossier management division/team examines the dossier and electronic data (if any), inputs it/them into and updates the dossier management program. Prints the list of health insurance buyers for their managing agency’s comparison and certification (Form DK06) and sends it to the health insurance buyer managing agency for examination and certification. Receives Form DK06 from the health insurance buyer managing agency and corrects the data (if any), grants a dossier code and then saves the data to the dossier management program and transfers the dossier to the social insurance book and health insurance card granting division/team.

- The social insurance book and health insurance card granting division/team checks the dossier and prints health insurance cards as prescribed; and sends the settlement results to the single-window division.

b/ The health insurance buyer managing agency:

- Receives Form DK06 from the social insurance agency to check and certify and returns it to the social insurance agency within 3 working days after receiving the list from the latter.

- Sums up and transfers funds or requests finance agencies to transfer funds to the health insurance fund as prescribed.

2. For persons whose health insurance premiums are covered by social insurance organizations

1.1. Step 1:

a/ The buyer registers the primary medical examination and treatment establishment with the social insurance agency and submits papers (if any) proving his/her enjoyment of higher health insurance benefits.

b/ The social insurance agency:

- The social insurance regime division/team makes the list of the increased and decreased number of health insurance buyers (Form D07-TS); and then transfers the list together with electronic data to the dossier management division/team.

- The dossier management division/team examines the dossier and electronic data, inputs them into and updates the dossier management program, grants a dossier code (if any) and transfers them to the social insurance book and health insurance card granting division/team.

- The social insurance book and health insurance card granting division/team checks the dossier and prints health insurance cards as prescribed; and sends the settlement results to the single-window division.

1.2. Step 2: Every month, the social insurance agency prints the list of buyers whose health insurance premiums are paid by social insurance organizations (Form DK05) and sends it to the commune-level People’s Committee for certification.

3. For persons whose social insurance premiums are partly covered by the state budget

3.1. Step 1:

a/ The buyer:

- Registers the payment method and the primary medical examination and treatment establishment with the premium collection agent or the social insurance agency.

- Pays his/her premium according to the registered payment method to the premium collection agent or the social insurance agency.

b/ The premium collection agent:

- Compares the list of health insurance buyers with the list of members of households living just above the poverty line; and members of agriculture, forestry, fisheries and salt production households that have average living standards approved by competent agencies.

- Makes a list of the buyers paying health insurance premiums themselves (Form DK04).

- Collects health insurance premiums and gives receipts to health insurance buyers.

3.2. Step 2:

The social insurance agency:

a/ The single-window division:

* For the premium collection agent,

- Receives Form DK04 and electronic data (if any) from the premium collection agent; checks the components and number of sets of the dossier and if it is correct and complete, guides the premium collection agent to hand the collected amount to the planning and finance division and writes the appointment paper.

- Transfers the dossier to the dossier management division/team.

* For the buyers paying health insurance premiums directly at the social insurance agency:

- Compares the list of health insurance buyers with the list of members of households living just above the poverty line; members of agriculture, forestry, fisheries and salt production households that have average living standards approved by competent agencies.

- Guides the buyers to pay their premiums at the planning-finance division and writes the appointment slip.

- Transfers the dossier to the dossier management division/team.

b/ The dossier management division/team:

- Examines the dossier and electronic data, inputs them into and updates the dossier management program, grants a dossier code and transfers the dossier to the planning-finance division/team.

- For the buyers paying their premiums directly at the social insurance agency: makes Form DK04, signs the form and sends it together with the buyer’s dossier to the planning-finance team for the latter to check and collect premiums from the buyers.

c/ The planning-finance division/team receives the dossier from the dossier management division/team; checks, signs and affixes the seal on the list made by the premium collection agent to certify the premium collection and transfers it to the social insurance book and health insurance card granting division/team.

d/ The social insurance book and health insurance card granting division/team checks the dossier and prints health insurance cards as prescribed; transfers the settlement results to the single-window division.

4. For household-based health insurance buyers

4.1. Step 1:

a/ The buyer:

- Registers the payment method; and the primary medical examination and treatment establishment with the premium collection agent or the social insurance agency.

- Pays his/her premium to the premium collection agent or the social insurance agency according to the registered payment method.

b/ The premium collection agent:

- Compares the list of health insurance buyers with the list of persons who have not yet participated in health insurance (Form DK03) provided by the social insurance agency.

- Makes a list of buyers paying health insurance premiums themselves (Form DK04).

- Collects health insurance premiums from the buyers and gives receipts to them.

4.2. Step 2:

The social insurance agency

a/ The single-window division:

* For the premium collection agent:

- Receives Form DK04 and electronic data (if any) from the premium collection agent; checks the components and number of sets of the dossier and if it is correct and complete, guides the premium collection agent to give the collected amount to the planning and finance division and writes the appointment slip.

- Transfers the dossier to the dossier management division/team.

* For the buyers paying their premiums directly at the social insurance agency:

- Compares the list of the buyers with the list of persons who have not participated in health insurance (Form DK03).

- Guides the buyers to pay their premiums to the planning-finance division, and writes the appointment slip.

- Transfers the dossier to the dossier management division/team.

b/ The dossier management division/team:

- Examines the dossier and electronic data, inputs them into and updates the dossier management program, issues a dossier code and transfers the dossier to the social insurance book and health insurance card granting division/team.

- For the buyers directly paying their premiums at the social insurance agency: makes Form DK04; signs the form and sends it together with the buyer’s dossier to the planning-finance team for the latter to check and collect premiums from the buyers.

c/ The planning-finance division/team:

- Receives the dossier from the dossier management division/team; checks, signs and affixes the seal certifying the collection of premiums on the list made by the premium collection agent and sends it to the social insurance book/health insurance card granting division/team.

d/ The social insurance book/health insurance card granting division/team checks the dossier and prints health insurance cards as prescribed; and sends the settlement results to the single-window division.

- The premium collection agent submits premiums directly at the single-window division or via postal services. Electronic data is sent via the Internet.

- The buyer pays his/her premium to the premium collection agent or directly at the social insurance agency.

- The premium collection agent directly submits the dossier to the single-window division or via postal services. Electronic data is sent via the Internet.

- The buyer submits his/her dossier to the premium collection agent or directly at the social insurance agency.

Within 7 working days after receiving a complete dossier as prescribed.

None