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| From July 1, the conditions for receiving health insurance for 5 consecutive years will change. (Source: TVPL) |
Change in health insurance conditions for 5 consecutive years from July 1, 2023
Currently, according to Decree 146/2018/ND-CP, the conditions for enjoying health insurance for 5 consecutive years include:
- Have participated in health insurance for 5 consecutive years or more;
- The amount of money spent on co-payment of medical examination and treatment costs in the year is greater than 6 months of basic salary.
Co-payment amount/co-payment cost is the amount that the patient with health insurance must pay together with the social insurance agency according to the % rate of the health insurance card type.
For example: If the health insurance card has a benefit level of 80%, the patient must co-pay 20% of the total cost covered by health insurance.
- Go to the right hospital for treatment.
Since from July 1, 2023, the basic salary will increase from VND 1,490,000 to VND 1,800,000, the amount of co-payment for medical examination and treatment costs during the year will also change.
Specifically, from January 1, 2023 to June 30, 2023, people participating in health insurance for 5 consecutive years or more have the amount of co-payment for medical examination and treatment costs in the year greater than VND 8,940,000 (6 months of basic salary of VND 1,490,000/month), the excess of 6 months of basic salary will be paid by the health insurance fund and the patient will be paid 100% of the medical examination and treatment costs from this time until the end of the year.
From July 1, 2023, when the basic salary increases to VND 1,800,000/month, people who have participated in health insurance for 5 consecutive years or more must have an amount of co-payment for medical examination and treatment costs in the year greater than VND 10,800,000 (6 months of basic salary) to enjoy health insurance benefits for 5 consecutive years.
In addition, from July 1, 2023, health insurance participants who go for medical examination and treatment in accordance with the provisions of the Law on Health Insurance with a one-time cost of less than VND 270,000 will be covered 100% by health insurance, and patients will receive free medical examination and treatment.
(Meanwhile, if applying the basic salary of 1,490,000 VND, the patient's medical examination and treatment costs must be less than 223,500 VND (15% of the basic salary of 1,490,000 VND/month) to be 100% covered by health insurance).
Cases of medical examination and treatment under health insurance in the right place
Cases identified as being in the correct health insurance treatment line include:
- Medical examination and treatment at the original registered place;
- Medical examination and treatment at the connected place;
- Medical examination and treatment with referral letter from the initial medical examination and treatment facility;
- Emergency;
- Medical examination and treatment during business trips, mobile work, or concentrated study must be performed at a medical examination and treatment facility of the same level or equivalent to the facility registered for initial medical examination and treatment. (See more here)
Change in family health insurance contribution rate from July 1, 2023
The health insurance premium for households is stipulated in Decree 146/2018/ND-CP, as follows:
First person: 4.5% of basic salary;
Second person: 70% of the first person's contribution (3.15% of basic salary).
Third person: 60% of the first person's contribution (2.7% of basic salary).
Fourth person: 50% of the first person's contribution (2.25% of basic salary).
Fifth person onwards: 40% of the first person's contribution (1.8% of basic salary).
From July 1, 2023, when the basic salary increases to VND 1,800,000/month, the family health insurance contribution level is as follows:
First person: 81,000 VND/month; 972,000 VND/year (before July 1: 67,050 VND/month; 804,600 VND/year).
Second person: 56,700 VND/month; 680,400 VND/year (before July 1: 46,935 VND/month; 563,220 VND/year).
Third person: 48,600 VND/month; 583,200 VND/year (before July 1: 40,230 VND/month; 482,760 VND/year).
Fourth person: 40,500 VND/month; 486,000 VND/year (before July 1: 33,525 VND/month; 402,300 VND/year).
From the fifth person onwards: VND 32,400/month; VND 388,800/year (before July 1: VND 26,820/month; VND 321,480/year).
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