Which cases are eligible for 100% health insurance?

Recently, the Government issued Decree No. 75/2023/ND-CP amending and supplementing a number of articles of Decree No. 146/2018/ND-CP detailing and guiding measures to implement a number of articles of the Law on Health Insurance (HI).

This new Decree has breakthrough provisions, removing "bottlenecks" in the payment mechanism for health insurance examination and treatment costs, in order to facilitate health insurance examination and treatment, ensuring the rights of health insurance participants...

At the same time, the new Decree supplements and supports the health insurance contribution level, amends the health insurance benefit level and strengthens the role and responsibility of ministries, branches, medical examination and treatment facilities in managing and effectively using the health insurance fund.

Which cases are eligible for 100% health insurance? — Decree No. 75 has increased the benefit level from 80% to 100% of health examination and treatment costs covered by health insurance for some groups of subjects. (Photo: SKDS)

Accordingly, Decree 75 added the subjects who are people in safe zone communes and revolutionary safe zones during the resistance war against France and the US, not subject to the provisions of Clauses 1, 2 and 3, Article 12 of the Law on Health Insurance, to the group of subjects whose health insurance is paid by the state budget.

At the same time, the Decree has added ethnic minorities living in communes in regions II, III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the period of 2016-2020, which are no longer on the list of communes in regions II, III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the period of 2021-2025 according to the Prime Minister 's decision, to the group of subjects receiving 70% state budget support for the contribution level for a period of 36 months from November 1, 2023.

These are ethnic minority groups that have just escaped poverty according to Decision No. 861/QD-TTg dated June 4, 2021 of the Prime Minister, but in reality, they are still facing many difficulties, as reflected and recommended by National Assembly Deputies, People's Committees of some provinces and voters.

Decree No. 75/2023/ND-CP has increased the benefit level from 80% to 100% of the cost of medical examination and treatment under health insurance for a number of groups of people with revolutionary contributions specified in Clause 5, Article 3 of Decree No. 146/2018/ND-CP such as youth volunteers; police officers and soldiers who have been granted benefits according to the provisions of the Prime Minister's Decisions; and frontline laborers.

Decree 75 also added the benefit level for the group of ethnic minorities who escaped poverty according to Decision 861/QD-TTg dated June 4, 2021 of the Prime Minister and the group of subjects that have been amended and supplemented in Decree 131/2021/ND-CP of the Government detailing and guiding measures to implement the Ordinance on Preferential Treatment for People with Meritorious Services to the Revolution. Decree 75/2023/ND-CP takes effect from December 3, 2023.

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