Why do some students have to pay health insurance for 15 months, instead of 12 months?

Many parents with children entering first grade in the 2025-2026 school year wonder why they have to pay health insurance for their children for 15 months instead of 12 months like students in other grades.

First graders have different payment levels based on their date of birth - Illustration photo: VNA

Parents also ask: is it correct to collect health insurance for 13, 14 or 15 months like that?

In fact, this regulation is related to the time when the child's health insurance card expires under the free health insurance program for children under 6 years old.

With up to 50% support, student health insurance premiums are reduced by more than 250,000 VND.

Currently, the health insurance premium for students is calculated at 4.5% of the basic salary. With the current basic salary of 2,340,000 VND/month, the total premium for 12 months is 1,263,600 VND.

From the 2025-2026 school year, the state budget will support at least 50%, meaning parents only need to pay a maximum of 631,800 VND/year, a decrease of more than 250,000 VND compared to the previous school year (when the support level was only 30%).

According to regulations, children under 6 years old are granted free health insurance cards by the State. When the child turns 6 years old, the card expires, and parents need to pay health insurance for their children so that their health care benefits are not interrupted.

However, the expiration date of the free health insurance card does not coincide with the school year. For example:

A child born on January 1, 2019 will be granted a free health insurance card until December 31, 2024 (6 years old).

If the child enters first grade in September 2025, parents must pay health insurance from January 2025 to the end of September 2026, which is 15 consecutive months.

Thanks to that, children will have continuous health insurance, without any "gaps" of time not covered by health insurance.

Health insurance premiums for 12 or 15 months are based on the child's date of birth.

Accordingly, the contribution level of first grade students is determined based on date of birth, specifically:

- Born from January 1, 2019 to October 1, 2019: Pay for 15 months → 52,650 VND x 15 = 789,750 VND

- Born from October 2, 2019 to November 1, 2019: Pay for 14 months → VND 52,650 x 14 = VND 737,100

- Born from November 2, 2019 to December 1, 2019: Pay for 13 months → 52,650 VND x 13 = 684,450 VND

- Born from December 2, 2019 to December 31, 2019: Pay for 12 months → 52,650 VND x 12 = 631,800 VND

Of which, 52,650 VND/month is the amount parents have to pay after receiving 50% support from the State.

Health insurance helps children pay for medical examination and treatment costs at public health facilities according to prescribed benefits and levels.

Paying for 15 consecutive months ensures that children do not have an interruption in their insurance coverage, especially during the transition period from being granted a free card to being a student.

Thus, paying 15 months of health insurance for first graders is not an additional or illegal fee, but to ensure the health benefits for children. Parents can choose to pay for a period of 3 months, 6 months or 12 months right at the school for more convenience in management and payment.

Children are covered 100% by health insurance in the following cases:

When receiving medical examination and treatment at the original registered place, students will have 80% of the cost covered by the health insurance fund.

In particular, the benefit level is 100% in the following cases: the cost for one medical examination and treatment is less than 351,000 VND; medical examination and treatment at the commune level; or having participated in health insurance for 5 consecutive years and the co-payment amount in the year exceeds 6 months of basic salary (14,040,000 VND).

In addition, students are entitled to 100% of the cost of inpatient medical examination and treatment at primary health facilities (district hospitals, commune health stations) nationwide, regardless of the place of initial registration.

In case of emergency, children are admitted and enjoy benefits at any medical facility.

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Source: https://tuoitre.vn/vi-sao-co-hoc-sinh-phai-dong-bao-hiem-y-te-15-thang-thay-vi-12-thang-2025091311505554.htm