Household health insurance regulations be amended

22/08/2024 02:45 PM


Under Decree 73/2024/NĐ-CP dated June 30, 2024, from July 1, 2024, the basic salary shall be 2.34 million VND/month. Therefore, the health insurance premiums for households

Illustrative image (internet)

Household health insurance is health insurance that is applied for households include all of the persons whose names are included in the family registers or temporary residence books, for non-profit purposes and organized by the State.

Household health insurance premiums payment

According to current regulations, the first member in a household pays a monthly health insurance premiums equal to 4.5% of the basic salary. The second, third, and fourth member pays 70%, 60%, and 50% of the first member's contribution respectively. From the fifth member onward, each pays 40% of the first member's contribution.

From July 1, 2024, the specific contribution levels are:

Household members

The health insurance premiums for household

The first member (100%)

1.263.600

The second member (70%)

884.520

The third member (60%)

758.160

The fourth member (50%)

631.800

The fifth member 

505.440

Health Insurance Contribution for Students and Pupils

According to current regulations, students belong to the group whose contributions are partially supported by the state budget. Additionally, students attending educational institutions within the national education system will participate in health insurance through their schools, not through household health insurance.

From July 1, 2024, the monthly health insurance contribution for students will be 4.5% of the basic salary (with 30% supported by the state budget, and the remaining 70% paid by the students themselves). Parents and students can choose to pay in four methods: 3 months, 6 months, 9 months, or 12 months at a time. The specific contribution levels are

Unit: VND/year

Payment methods

Puplis, Students pay 70%

The state budget support 30%

Total health insurance contributions

3 months

221.130

94.770

315.900

6 months

442.260

189.540

631.800

9 months

663.390

284.310

947.700

12 months

884.520

379.080

1.263.600

 

 

The Ministry of Health has proposed amendments to the draft Law on Health Insurance, which stipulates that patients under 18 years old undergoing treatment for strabismus, myopia and eye refractive errors will be covered by health insurance.

Currently, the Health Insurance Law only covers children from 0 to six years old.

This is one of the ministry’s proposals to expand the age range covered by health insurance in the draft amended Health Insurance Law.

The draft law has adjusted the scope of participants in health insurance; the scope of health insurance benefits; and the health insurance regulations according to the level of technical expertise in medical facilities.

It has also improved efficiency in appraisal management and implementation of health insurance medical treatment contracts and efficient allocation of health insurance funds.

The ministry has proposed to amend some content of Article 22, in which patients who seek medical treatment at hospitals or healthcare facilities not at the appropriate technical level or outside the basic level will have two options for health insurance benefits.

In Option 1, patients with health insurance will be reimbursed 60 per cent of inpatient costs and 40 per cent of outpatient costs, except for district-level facilities which will supply 100 per cent for both inpatient and outpatient.

In Option 2, the current provisions will be applied with 100 per cent reimbursement of inpatient treatment costs and no payment for outpatient costs.

Additionally, the draft law has stipulated not to cover health insurance for the use of substitute medical supplies, including prosthetic eyes, dentures, eyeglasses and mobility aids during medical examination and treatment as well as functional rehabilitation.

Currently, health insurance funds don’t cover the use of substitute medical supplies such as prosthetic limbs, prosthetic eyes, dentures, eyeglasses, hearing aids and mobility aids. Therefore, health insurance participants will only be reimbursed for prosthetic limbs and hearing aids.

The draft law has also retained cases where health insurance does not cover expenses, including nursing at nursing facilities; health check-ups; prenatal diagnostics not intended for treatment.

Use of reproductive assistance techniques, family planning services and abortion are not on the reimbursement list except for cases where pregnancy termination is required due to pathological reasons. The health insurance funds don’t cover cosmetic services, functional rehabilitation in cases of disaster, medical examination and treatment for addiction to drugs, alcohol, or other addictive substances, forensic examination and psychiatric forensic examination.

The draft law has also reduced the allocated amount for management expenses with the excess amount to be transferred directly to medical examination and treatment. Accordingly, the maximum expenses for health insurance fund management activities will be reduced from 5 per cent as currently to a maximum of 4 per cent. The remaining will be immediately added to the health insurance medical examination and treatment.

PV