The leader of the Provincial Social Insurance (SSI) said: On October 19, 2023, the Government issued Decree No. 75/2023/ND-CP amending and supplementing a number of articles of Decree 146/2018/ND-CP of the Government detailing and guiding measures to implement a number of articles of the Law on Health Insurance (HI), including adding the subject "Ethnic minority people (EM) living in communes in region II, region III, extremely difficult villages in ethnic minority and mountainous areas in the period 2016-2020, but these communes are no longer on the list of communes in region II, region III, extremely difficult villages in ethnic minority and mountainous areas in the period 2021-2025 according to the decision of the Prime Minister" to be supported by the state budget to pay 70% of the HI premium (participants pay 30% of the premium). Health insurance).
Based on the above regulations, localities have made a list of proposals to issue health insurance cards to ethnic minorities living in communes including: Communes in region II, region III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the period 2016-2020, but these communes are no longer on the list of communes in region II, region III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the period 2021-2025 according to the Prime Minister 's decision.
Communes in region II, region III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the 2016-2020 period, which are included in the list of communes in region I and extremely disadvantaged villages in ethnic minority and mountainous areas in the 2021-2025 period according to the Prime Minister's decision.
Ethnic minorities living in communes in regions II, III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the period 2016-2020 and 2021-2025 are still identified as communes in regions II, III, and extremely disadvantaged villages but are recognized as meeting new rural standards and are identified as new rural communes (according to Decision No. 861/QD-TTg, they are identified as communes in region I).
On March 1, 2024, the Ministry of Health issued Official Dispatch No. 917/BYT-BH on the implementation of Decree No. 75/2023/ND-CP. According to the instructions in this Document, the subjects in the second and third bullet points of this Document are not included in the group of subjects supported by the state budget to pay health insurance.
Before the above regulation, the provincial Social Insurance has issued a report and requested the People's Committee to direct relevant agencies: the Ethnic Committee, the Department of Labor, War Invalids and Social Affairs to guide localities to identify subjects in the group of subjects supported by the state budget to pay health insurance; direct localities to urgently propagate and mobilize ethnic minorities (not supported by the state budget) to participate in health insurance. For ethnic minorities who have participated (only paid 30% of the health insurance premium): pay the full health insurance premium according to the subjects of the household.
In case ethnic minorities have participated in health insurance but do not continue to pay enough
The health insurance premium payment level depends on the household member. The social insurance agency will review and stop the use of the health insurance card when the expiration date corresponds to the amount the participant has paid (calculated according to the contribution level of the household member) to ensure proper implementation of the instructions in Official Dispatch No. 917/BYT-BH.
For localities, the provincial Social Insurance directs professional departments and district Social Insurance to urgently report and advise the district People's Committee to direct relevant agencies and commune-level People's Committees to urgently notify ethnic minorities who are not supported by the State budget to pay health insurance to propagate and mobilize them to register for health insurance, pay and collect money according to the subjects of the household.
For ethnic minorities who are participating, but are not eligible for State budget support to pay health insurance according to the instructions in Official Dispatch No. 917/BYT-BH (only paying 30% of the health insurance premium): Calculate the full health insurance premium according to the household member corresponding to the amount paid (30%); at the same time, reduce the DS code card and reissue the GD code health insurance card (if there is any remaining money) with a term corresponding to the excess paid amount.
Check and review other health insurance participants, from November 1, 2023 to present, it has been proposed to change the health insurance benefit level (95%) according to the subjects specified in Clause c, Point 2, Article 1 of Decree No. 75/2023/ND-CP, but not subject to the State budget support for health insurance payment according to the instructions in Official Dispatch No. 917/BYT-BH to adjust the benefit level and reissue the health insurance card.
Compile and report in writing to the provincial Social Insurance on the status of participation, issuance of health insurance cards and the results of reducing and reissuing cards for ethnic minorities according to Decree No. 75/2023/ND-CP. The time of statistics is from November 1, 2023 to present. The reporting deadline is before March 15, 2024.
District Health Insurance and Social Insurance Appraisal Department: For cases of people participating in health insurance under Clause 2 of this Document who are being treated at medical examination and treatment facilities, coordinate with health insurance medical examination and treatment facilities to notify patients (with health insurance card code "DS") to continue participating in health insurance, instruct patients to pay according to the contribution level for people in households (health insurance card code GD) and the benefit level according to the health insurance card benefit code.
Assign the Collection and Card Management Department to summarize and report on the participation situation, issuance of health insurance cards, and results of processing health insurance cards for ethnic minorities according to Decree No. 75/2023/ND-CP before March 16, 2024.
Peaceful
Source
Comment (0)