From January 1, 2021, does the health insurance apply inter-agency at provincial level for outpatient diseases? When applying a full-term health insurance card for 5 consecutive years, is it required to satisfy 2 conditions: medical care at primary level and for more than 6 months of base salary in the year or only 1 of the 2 above conditions?
According to the provisions of Point b, Clause 3 and Clause 6, Article 22 of the Law on Health Insurance, from January 1, 2021, the health insurance fund shall pay inpatient treatment costs at the benefit levels for the insured who receive medical care at improper provincial-level medical care providers nationwide.
Thus, the case that the health insurance cardholder receives outpatient care of the improper level at the provincial hospital will not be covered by the health insurance fund.
- A participant of health insurance for full 5 consecutive years will be covered at 100% of medical expenses by the health insurance fund within the scope of health insurance entitlement when the following 2 conditions are fully met:
+ The total amount of money paid for medical care costs of all turns of medical services at the primary level in a year is greater than 06 months' base salary.
+ Taken medical care at primary level as prescribed.
Sickness
Work Injury and Occupational Disease
Survivor’s
Old-age
Maternity
Unemployment
Medical (Health Insurance)
Certificate of coverage
VSS - ISSA Guidelines on Social Security
