The decree will take effect from December 1, 2018.

Electronic health insurance cards to be issued on January 1, 2020 at the latest

The decree classifies the following six groups of health insurance card holders: those whose contributions are paid by both employees and employers, those whose contributions are paid by social insurance agencies, those whose contributions are funded by the State budget, those enrolled under the family plan, and those whose contributions are paid only by employers.

Illustrative image (Source: Internet)

The decree also stipulates that health insurance cards issued by social insurance agencies must cover the following information.

1. Personal information of the card holder, including name, gender, date of birth, address of residence or place of work.
2. Health insurance health benefit plan.
3. Date of validity.
4. Hospital or medical clinic registered as first place for health checkup.
5. Previous continuous period the cardholder was covered by health insurance, at most for five consecutive years, for people who partly pay for the contributions. The period the cardholder was continuously insured means the term of validity written on the current card which starts from the date of expiry of the previous card – the interruption, if any, should not exceed three months.
6. Photograph of health insurance cardholder (except for children aged under 6), applicable to people whose personal identity verification documents were issued by competent authorities or commune-based police, or those granted by education or vocational training providers where the insured persons study, or other legal identity verification papers that do not contain a photo.

The decree regulates that social insurance agencies shall have to issue electronic health insurance cards for all cardholders by January 1, 2020 at the latest.

Five cases eligible to be covered with 100 percent of medical expenses

The decree outlines three levels of health insurance benefits – 80 percent, 95 percent and 100 percent, for different insured persons.

Accordingly, 100 percent of the medical care costs shall be covered by the health insurance fund for the five cases as follows.

First of all, the health insurance shall cover 100 percent of medical care costs for people with merited services to the revolution; war veterans; people on monthly social welfare allowances; poor household members, ethnic minority people living in areas with difficult or exceptionally difficult socio-economic conditions; relatives of people with merited services to the revolution; and people aged 80 years old and above who are on a monthly survivorship allowance.

Secondly, people who rendered their services to the nation before 1945, heroic mothers, war invalids, people exposed to Agent Orange, those who have lost more than 81 percent of their working capacity, and children under six years old will receive free medical examinations and treatment. Meanwhile, for those people, there will also be no payment limitations for medicines, chemicals, medical supplies, and technical services.

Thirdly, health insurance will provide free medical checkups and treatment at the communal level.

Fourthly, free medical checkups and treatment will be given to those who spend less than 15 percent of their minimum wages on each medical examination (the minimum wage is currently at 1.39 million VND per month). And

Fifthly, free medical examinations and treatment for patients who have joined the health insurance scheme for at least five consecutive years and been spending on medical examinations and treatment within a year higher than their minimum wages in six months, excluding those who have medical checkups and treatment at hospitals they have not registered at to use health insurance.

Health insurance fees

The decree regulates monthly health insurance fees for different beneficiaries:

The monthly fee for health insurance is equal to 4.5 percent of the monthly wage of the labourers who have indefinite duration contracts or definite contracts with a term from three months, such as managers of non-state businesses, managers of cooperatives, officials, and civil servants.

-   Labourers taking sick leave of more than 14 days in line with the legal regulations on social insurance will not have to pay health insurance costs but are allowed to enjoy their health insurance rights.

-   Health insurance fees for labourers in custody, detention, or work suspension have been under investigation to decide whether they violate the law or not, equal to 4.5 percent of their half monthly wage. When relevant authorities conclude that the labourers do not violate the law, they will get two weeks in arrear to pay.

The monthly fee for health insurance is 4.5 percent of the pension and incapacity allowance.

The monthly fee for health insurance makes up 4.5 percent of the monthly wage before the labourers’ maternity leave.

The same level is applied for those who are enjoying unemployment allowance.
Other people will have to spend 4.5 percent of their monthly wage on health insurance costs.

The health insurance premiums for those who want to buy health insurance as a group of family members is regulated as follows: the first person contributes 4.5 percent of the basic salary; the second, third, and fourth, respectively contribute 70 percent, 60 percent, and 50 percent of the first person’s payment; while for the fifth person onwards, the rate of payment is equal to only 40 percent of the premium paid by the first person.

The deduction of health insurance premiums will be made when all members of the household buy the health insurance in the same fiscal year.

Support level of State budget for special buyers of health insurance

As of December 1, 2015, the level of support for health insurance premiums from the state budget is as follows:

Those from near-poor households living in poor districts – in accordance with the Government’s Resolution No.30a/2008/NQ-CP dated December 27, 2008 on supporting the programme of rapid and sustainable poverty reduction applied in line with the resolution – will receive support of 100 percent of all health insurance premiums.

Those from near-poor families in line with near-poor standards prescribed by the Government or the Prime Minister; those from poor multi-dimensional households who do not belong to poor households according to the income criteria; those from multi-dimensional poor households that lack health insurance under Decision No.59/2015/QD-TTg dated November 19, 2015 by the Prime Minister on promulgating the multi-dimensional approach standards for the 2016-2020 period and other decisions by competent agencies which have the right to amend, supplement, or replace the poverty standard applied for each phase, will receive the minimum support of 70 percent of the health insurance premiums.

Pupils, students, and those from agricultural, forestry, fishery, and salt production households which have mid-range living standards as prescribed by the Government or the Prime Minister will received a minimum support of 30 percent of their health insurance premiums.

In cases where one person is a beneficiary of all the above-mentioned policies, they will receive the highest support.

People's Committees of provinces and centrally-run cities shall, on the basis of the local budget capacity and other lawful sources, including 20 percent of the fund stipulated at Point a, Clause 3, Article 35 of the Law on Health Insurance, build and submit proposals to the provincial People’s Councils for making decisions on a higher support level of health insurance premium payment than the minimum support level.