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On October 26, Vietnam Social Security (VSS) issued Official Dispatch 3425/BHXH-CSYT on the implementation of card issuance and health insurance (HI) exchange according to the provisions of Decree 75/2023/ND-CP.
The level of health insurance benefits can be known through the health insurance card number.
Vietnam Social Security has just issued an official dispatch to Social Security of provinces and cities, Social Security of the Ministry of National Defense and Social Security of the People's Public Security on the implementation of 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.
To promptly implement Decree No. 75, Vietnam Social Security requests provincial Social Security agencies to issue and exchange health insurance cards according to regulations, including converting health insurance benefit codes according to regulations in Clause 5, Article 1 of this Decree (people participating in the resistance war and defending the Fatherland; people serving people with revolutionary contributions living at home).
The health insurance card benefit code is currently encoded in the second box on the health insurance card, symbolized by a digit in order from 1 to 5; (Example: CC 1; CB 2; HT 3; DN 4; QN 5 ...). Specifically:
- Symbol number 1: 100% of medical examination and treatment costs covered by health insurance are paid by the health insurance fund and there is no limit on the payment rate for some drugs, chemicals, medical supplies (VTYT) and technical services (DVKT) according to the regulations of the Minister of Health on the list and rate, conditions for payment of technical services; costs of transporting patients from district level to higher level in emergency cases or when inpatient treatment requires transfer to a technical specialist level.
- Symbol number 2: 100% of medical examination and treatment costs covered by health insurance are paid by the health insurance fund (with a limit on the payment rate for some drugs, chemicals, medical supplies and technical services according to regulations of the Minister of Health); costs of transporting patients from the district level to a higher level in emergency cases or when inpatient treatment requires technical transfer.
- Symbol number 3: The Health Insurance Fund pays 95% of medical examination and treatment costs within the scope of health insurance payment (with a limit on the payment rate for some drugs, chemicals, medical supplies and technical services according to regulations of the Minister of Health); 100% of medical examination and treatment costs at the commune level and the cost for one medical examination and treatment is lower than 15% of the basic monthly salary.
- Symbol number 4: The Health Insurance Fund pays 80% of the medical examination and treatment costs within the scope of health insurance payment (with a limit on the payment rate for some drugs, chemicals, medical supplies and technical services according to regulations of the Minister of Health); 100% of the medical examination and treatment costs at the commune level and the cost for one medical examination and treatment is lower than 15% of the basic monthly salary.
- Symbol number 5: 100% of medical examination and treatment costs are paid by the Health Insurance Fund, including medical examination and treatment costs outside the scope of health insurance benefits; transportation costs.
Accordingly, Vietnam Social Security requests provincial Social Security to issue cards and change health insurance according to the provisions of Decree 75 as follows:
Firstly, convert the health insurance benefit level code according to the provisions of Clause 5, Article 1 of Decree 75:
- Change the health insurance benefit level from code 4 to code 2 for people participating in the resistance war and defending the Fatherland (with subject code KC) as prescribed in Clause 5, Article 3 of Decree No. 146/2018/ND-CP.
Change the health insurance benefit level from code 4 to code 3 for people serving revolutionary contributors living at home.
- Change the health insurance benefit level from code 4 to code 3 for people serving people with revolutionary contributions living in their families (with subject code PV) as prescribed in Clause 19, Article 3 of Decree No. 146/2018/ND-CP.
Second, supplement the subject code and benefit level code recorded on the health insurance card for new health insurance participants as prescribed in Decree 75 and Decree 131/2021/ND-CP:
- While waiting for amendments to Decision No. 1351/QD-BHXH dated November 16, 2015, the Social Insurance of the provinces shall coordinate with the subject management unit to review, make a list and issue health insurance cards to the subjects added in Decree 75 as follows:
Wives or husbands of martyrs who marry another person and are receiving monthly allowances: the object code is TG and the benefit level code is number 3; the management block code is WG, the statistical block code is 37.
People in safe zone communes and revolutionary safe zone areas during the resistance war against France and the US currently residing in safe zone communes during the resistance war against France and the US: the object code is AK and the benefit level code is number 2; the management block code is WK, the statistical block code is 61.
Ethnic minorities living in communes in regions II, III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the period 2016-2020, but these communes 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 2021-2025: the object code is DS and the benefit level code is number 3; the management block code is WS, and the statistical block code is 62.
Third, in case the health insurance participant belongs to many different subjects, if the old health insurance card issued to another subject has a lower benefit level than the new regulation, then the highest benefit level will be applied.
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