Health insurance premiums will change from July 1

People do procedures for health insurance at a hospital in Ho Chi Minh City - Photo: DUYEN PHAN

Accordingly, the health insurance premium is determined as a percentage of the salary used as the basis for compulsory social insurance premium payment according to the provisions of the Law on Social Insurance (including monthly salary, pension, allowance or reference level).

Maximum contribution is 6% of salary

Salaries, wages, and allowances used as the basis for paying health insurance are regulated as follows:

For employees subject to the salary regime prescribed by the State, the basis for paying health insurance is the monthly salary according to the salary scale, military rank and position allowances, seniority allowances beyond the framework, seniority allowances (if any).

For employees receiving salaries and wages according to the regulations of the employer, the basis for payment is the monthly salary and wages stated in the labor contract.

For pensioners, beneficiaries of monthly disability allowances and unemployment benefits, the basis for payment is the monthly pension, disability allowance and unemployment benefits.

For subjects not belonging to the above groups, the closing basis is the reference level.

The maximum monthly salary to calculate the health insurance contribution is 20 times the reference level.

The maximum contribution rate is 6% of monthly salary, of which the employer contributes 2/3 and the employee contributes 1/3.

According to the old regulations, the maximum contribution level was 4.5% of monthly salary.

In addition to the old health insurance participants, the revised Health Insurance Law stipulates 7 additional groups of subjects required to participate in health insurance.

Including: employees with labor contracts of 1 month or more; business owners of registered business households who are subject to compulsory social insurance according to the provisions of the law on social insurance.

Workers who are foreign citizens in certain cases; workers working under labor contracts agreed with employers for part-time work; people taking sick leave or maternity leave for 14 days or more; village and hamlet health workers; victims of human trafficking, folk and elite artisans... and some other subjects.

Change in family health insurance contribution level

According to current regulations, the first person's health insurance contribution is equal to 4.5% of the basic salary.

The second, third, and fourth person pay 70%, 60%, and 50% of the first person's contribution, respectively. From the fifth person onwards, the contribution is 40% of the first person's contribution.

From July 1, family members who participate in family health insurance in the fiscal year will have their first person's contribution reduced by a maximum of 6% of the reference level.

The second, third, and fourth person pay 70%, 60%, and 50% of the first person's contribution, respectively. From the fifth person onwards, the contribution is 40% of the first person's contribution.

Regarding the reference level, according to the above regulations, the basic salary level is applied. In case of changes in salary policy, the Government will decide on the specific reference level.

What is the scope of benefits for health insurance participants?

From July 1, health insurance participants will be paid by the health insurance fund for other expenses beyond current regulations such as medical examination and treatment, including remote medical examination and treatment, support for remote medical examination and treatment, family medical examination and treatment, medical examination and treatment at home, rehabilitation, periodic pregnancy check-ups, and childbirth.

Transporting patients for subjects specifically regulated in case of inpatient or emergency treatment must be transferred to medical examination and treatment facilities according to regulations.

Costs for using medical technical services, drugs, medical equipment, blood, blood products, medical gases, supplies, tools, instruments, and chemicals used in medical examination and treatment are covered by the health insurance fund.

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LINH HAN

Source: https://tuoitre.vn/muc-dong-bao-hiem-y-te-se-co-nhieu-thay-doi-tu-ngay-1-7-20250504190906684.htm