Vietnam Social Insurance said that Article 20 of Consolidated Document No. 2525/VBHN-BHXH dated August 15, 2023 of Vietnam Social Insurance stipulates 3 cases participating in health insurance that will be refunded, specifically as follows:
Case 1: Participants are issued health insurance cards according to the new group of subjects, now report a reduction in the value of the previously issued card.
The condition to receive a refund of health insurance is that people are then issued health insurance cards under another group of subjects.
For example: When a household member participates in household health insurance, they are then hired to work at a company and are issued a health insurance card paid by the company. In this case, the health insurance card that the household has paid for before will have its value reduced (due to the health insurance card according to the new subject having a higher priority order). At this time, people will be refunded the amount of money they have paid for the unused period.
Case 2: The State budget will adjust the health insurance contribution level to increase support.
In case of health insurance refund when the policy changes and a certain group of subjects is entitled to a higher health insurance payment support level than before.
Case 3: The participant died before the health insurance card was valid.
In case the buyer of the health insurance card dies before the card is valid, the deceased's family will be refunded the entire amount of money paid to the unused health insurance card.
Principles for calculating the amount of health insurance refunds
For the above 3 cases, the refund amount is calculated according to the health insurance payment level and the time the money has been paid but the card has not been used. Specifically:
- Case 1: The period of not using the card is calculated from the time the health insurance card according to the new group of subjects takes effect.
- Case 2: The time for not using the card is calculated from the time the decision to adjust the support level takes effect.
- Case 3: The period of not using the card is calculated from the time the health insurance card begins to be valid.
According to Clause 2, Article 13 of the Law on Health Insurance amended in 2014, if a person is also a member of many different health insurance participants at the same time, he/she will pay health insurance according to the first subject, which person is determined in order.
Article 12 of the 2014 amended Law on Health Insurance stipulates the order of subjects participating in health insurance as follows:
1. The group is paid by employees and employers.
2. The group is paid by the social insurance organization.
3. The group is paid for by the State budget.
4. The group is supported by the State budget for the contribution level.
5. Group participating in health insurance by household.
According to Vietnam Social Insurance, the number of people participating in health insurance nationwide is estimated at 92.104 million people, an increase of 2.004 million people, equivalent to 2.22% over the same period in 2024.
The rights of health insurance participants are always guaranteed. According to the Law amending and supplementing a number of articles of the Law on Health Insurance effective from July 1, health insurance participants will have many additional benefits, in which the clearance of health insurance examination and treatment without administrative geographical advantage and patients are entitled to health insurance when meeting the prescribed conditions...
Mr. Duong Tuan Duc, Head of the Health Insurance Policy Implementation Board under Vietnam Social Insurance, said that the health insurance participation rate of people and medical examination and treatment facilities is increasing.
According to statistics in 2024, the country has nearly 10,000 health stations; 1,300 clinics; 437 specialized hospitals and 1,119 general hospitals registered for health insurance examination and treatment. Among them, non-public facilities registering for health insurance examination and treatment have increased over the years. In 2018, 647 medical examination and treatment facilities increased to 1,132 in 2024.
Mr. Duc assessed that the level of development of public and non-public medical examination and treatment facilities has currently met the needs of medical examination and treatment of the people. In particular, the wide network of health stations - primary medical examination and treatment facilities nationwide.
