Group of people whose health insurance fund covers 100% of medical examination and treatment costs, do not know the overcharge

Specifically, according to the provisions of Article 14 of Decree 146/2018, there are 5 groups of subjects entitled to 100% of medical examination and treatment costs under Health Insurance (HI), including:

Group 1: Subjects are people with revolutionary contributions, war veterans, people receiving monthly social insurance benefits, people from poor households, ethnic minorities in difficult or extremely difficult areas, relatives of people with revolutionary contributions, people aged 80 or older receiving monthly survivor benefits.

The second group is supported 100% of medical examination and treatment costs and there is no limit on the rate of payment for drugs, chemicals, medical supplies and technical services as prescribed by the Ministry of Health . These subjects include those who participated in the revolution before 1945; Vietnamese heroic mothers; war invalids, people who enjoy policies like war invalids, war invalids of type B, sick soldiers when treating wounds, recurrent diseases; resistance fighters infected with toxic chemicals with a rate of labor capacity reduction of 81% or more; children under six years old.

The third group is those who receive medical examination and treatment at the commune level.

The fourth group is cases where the cost of medical examination and treatment at the right facility is less than 15% of the basic salary. The current basic salary is 1,800,000 VND/month, 15% of the basic salary is equivalent to 270,000 VND.

The fifth group is those who have participated in health insurance for five consecutive years or more, and have the amount of co-payment for medical examination and treatment costs in the year greater than six months of basic salary (6 months of basic salary is currently 10,800,000 VND).

Health insurance is an insurance regime of the Party and the State to take care of people's health, protected by the State, organized and implemented by the Social Insurance agency for non-profit purposes.

Participating in health insurance brings many practical benefits to people, especially low-income families when they are unfortunately sick or ill. Health insurance also has a profound humanitarian meaning for the community because when everyone participates in health insurance together, healthy people will support those who are unfortunately sick. Thereby, it contributes significantly to the implementation of social justice in caring for and protecting people's health.

By the end of 2022, the whole country had 91.074 million people participating in health insurance; reaching 92.04% of the population (exceeding 0.04% compared to the target in Resolution 01/NQ-CP); an increase of 2.237 million people compared to 2021, which is one of the 7 socio- economic targets exceeding the 2022 plan assigned by the National Assembly and the Government.

From October 15, Hanoi will stop printing paper health insurance cards to give to people receiving unemployment benefits.

In recent times, digital transformation in the field of social insurance and health insurance in Hanoi city has achieved many results, creating convenience and satisfaction for participants and beneficiaries of social insurance and health insurance policies.

To continue simplifying paperwork and procedures, saving time for people, from October 15, Hanoi Social Security will stop printing paper health insurance cards and sending them to the Employment Service Center to pay for workers receiving unemployment benefits as is currently the case.

Instead, the card renewal is carried out on the data system managed by the industry and the employee receiving unemployment benefits continues to use the old social insurance code before stopping receiving unemployment benefits.

In addition, the City Employment Service Center is also requested to immediately inform employees when they come to submit their unemployment benefit applications about the suspension of printing paper health insurance cards by the Social Insurance Agency from October 15 so that employees know and cooperate in implementation.

Workers can use the previously issued paper health insurance card to go to the hospital for health insurance examination and treatment. At the same time, the City Employment Service Center continues to coordinate to propagate to workers when submitting unemployment benefit applications to install the VssID application "Digital Social Insurance" to look up information.

In addition, health insurance medical examination and treatment facilities coordinate to guide and receive health insurance cards on the VssID application, VNeID electronic identification application, and chip-embedded Citizen Identification Cards to perform medical examination and treatment for people and workers, ensuring full rights according to regulations.

In case the health insurance participant comes to transact at medical examination and treatment facilities but has not installed or has installed but has not successfully activated the VssID application, the VNeID level 2 electronic identification application (with integrated health insurance card), the chip-embedded citizen identification card has not been synchronized with health insurance participation data..., please contact directly the hotline of the Hanoi City Social Insurance agency for resolution.

In response to comments about some elderly people who are used to using paper insurance cards and have difficulty accessing information technology applications, the city's Social Insurance Agency said that if requested, paper insurance cards will still be issued.

Minh Hoa (t/h)

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