{"id":2343,"date":"2022-10-12T15:13:03","date_gmt":"2022-10-12T08:13:03","guid":{"rendered":"https:\/\/athenacorp.vn\/what-significance-does-having-a-health-insurance-card-indicating-continuous-coverage-for-5-years-hold\/"},"modified":"2024-06-05T09:49:30","modified_gmt":"2024-06-05T02:49:30","slug":"what-significance-does-having-a-health-insurance-card-indicating-continuous-coverage-for-5-years-hold","status":"publish","type":"post","link":"https:\/\/athenacorp.vn\/en\/what-significance-does-having-a-health-insurance-card-indicating-continuous-coverage-for-5-years-hold\/","title":{"rendered":"What significance does having a Health Insurance Card indicating continuous coverage for 5 years hold?"},"content":{"rendered":"\n
If one has contributed to health insurance (BHYT) for 5 consecutive years, they all have the opportunity to enjoy 100% payment coverage. So, what is the correct understanding of the BHYT 5-year continuous scheme?<\/div>\n

1. What is the BHYT 5-year continuous scheme?<\/strong><\/h4>\n
It refers to a situation where the participant has consistently paid into BHYT for 5 years, with a maximum allowable interruption of 3 months.<\/div>\n
The moment someone achieves 5 consecutive years is directly recorded on their health insurance card. According to Decision No. 1666\/Q\u0110-BHXH dated 2020, the recognition of the 5-year continuous period is stipulated as follows:<\/div>\n
– For those who have completed 5 continuous years of BHYT participation by January 1, 2015, the date is printed from January 1, 2015.<\/div>\n
– From January 1, 2015 onwards, for those who have not yet completed or have just completed 5 consecutive years, the date is printed from the first day of the sixth year.<\/div>\n

2. Conditions for enjoying the BHYT 5-year continuous scheme:<\/strong><\/h4>\n
According to Article c, Clause 1 of the Health Insurance Law of 2008, as amended in 2014, beneficiaries must meet the following conditions:<\/div>\n
1 – Have participated in BHYT for a continuous 5-year period, as recorded on the health insurance card.<\/div>\n
2 – Having the same amount of co-payment for medical expenses within the year exceeding 6 months of the base salary.<\/div>\n
The co-payment amount is understood as the sum that patients must jointly contribute with the Social Insurance Agency at the percentage rate specified on the Health Insurance Card.<\/div>\n
3 – Seeking medical treatment at the correct facility.<\/div>\n
According to Article 6 of Circular No. 30\/2020\/TT-BYT, seeking medical treatment at the correct facility includes the following cases:<\/div>\n
+ Insured individuals visit the medical facility listed on their Health Insurance Card.<\/div>\n
+ Registering for initial medical treatment at the commune or district level and seeking treatment at facilities within the same level in the same province.<\/div>\n
+ Emergency medical treatment.<\/div>\n
+ Insured individuals are referred to another facility…<\/div>\n
\"Conditions<\/a><\/div>\n

3. Benefits of continuous 5-year Health Insurance:<\/strong><\/h4>\n
When meeting the aforementioned conditions, participants of the Health Insurance Scheme (BHYT) will enjoy 100% coverage of medical expenses within the scope of the BHYT fund.<\/div>\n
Specifically, Article 3 of Decree No. 146\/2018\/N\u0110-CP stipulates the following:<\/div>\n
* Patients who co-pay for medical treatments, either in a single instance or multiple instances at the same medical facility, exceeding 6 months of the base salary:<\/div>\n
– Are not required to pay co-payment amounts exceeding 6 months of the base salary.<\/div>\n
– Are issued invoices with co-payment amounts equivalent to 6 months of the base salary, ensuring they are not required to co-pay for medical expenses within that year.<\/div>\n
* Patients who accumulate co-payment amounts for medical treatments across different medical facilities within a fiscal year, or at the same facility, exceeding 6 months of the base salary:<\/div>\n
– Must still settle the entire co-payment amount for the medical facility.<\/div>\n
– Are reimbursed directly by the Social Insurance Agency for co-payment amounts exceeding 6 months of the base salary.<\/div>\n
Note: If a patient’s co-payment amount exceeds 6 months of the base salary, calculated from January 1st, the BHYT fund will only cover 100% of medical expenses within the benefit entitlement period, starting from the date the individual completed 5 consecutive years of participation until December 31st of that year.<\/div>\n

4. Procedures for Enjoying Continuous 5-Year Health Insurance<\/strong><\/h4>\n
In accordance with Clause 3 of Article 27 of Decree No. 146\/2018\/N\u0110-CP and Circular No. 2298\/TB-BHXH, to fully enjoy the benefits of participating in 5 consecutive years of Health Insurance, patients need to follow these steps:<\/div>\n
Case 1: When the co-payment for medical treatments, either in a single instance or multiple instances at the same medical facility, exceeds 6 months of the base salary.<\/div>\n
Simply follow the correct procedures for medical treatment without having to pay the co-payment amount exceeding 6 months of the base salary.<\/div>\n
Case 2: When the accumulated co-payment amount for medical treatments across different medical facilities within a fiscal year, or at the same facility, exceeds 6 months of the base salary.<\/div>\n
– Visit the Social Insurance Agency where the Health Insurance Card was issued to request reimbursement for the co-payment amount exceeding 6 months of the base salary.<\/div>\n
– Bring the following documents:<\/div>\n
+ Health Insurance Card.<\/div>\n
+ Copy of personal identification with photo.<\/div>\n
+ Original invoice for medical expenses.<\/div>\n
\"Understand<\/a><\/div>\n

5. Procedures for Replacing Continuous 5-Year Health Insurance Card in Case of Errors<\/strong><\/h4>\n
Despite the direct printing of the 5-year continuous participation period on the Health Insurance Card, many individuals encounter errors during the card replacement process.<\/div>\n
In Circular No. 238\/BHXH-CNTT issued in 2018, the Social Insurance Agency of Vietnam instructed provincial branches as follows:<\/div>\n
Replace Health Insurance Cards on the same working day when the managing unit or Health Insurance participant applies for a card replacement due to errors in the participation period.<\/div>\n
Therefore, if there are errors regarding the completion of 5 consecutive years of participation on the Health Insurance Card, individuals only need to visit the Social Insurance Agency where the card was issued to request a replacement.<\/div>\n
Processing time: Within the same working day.<\/div>\n
<\/div>\n
This information about continuous 5-year Health Insurance participation is essential for everyone to fully enjoy their benefits.<\/div>\n
___________<\/div>\n
Source: Vietnamese Law<\/div>\n","protected":false},"excerpt":{"rendered":"

If one has contributed to health insurance (BHYT) for 5 consecutive years, they all have the opportunity to enjoy 100% payment coverage. So, what is the correct understanding of the BHYT 5-year continuous scheme?<\/p>\n","protected":false},"author":1,"featured_media":694,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[112,39],"tags":[237,234,235,236,238],"class_list":["post-2343","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-other_categories","category-posts","tag-5-consecutive-years","tag-health-insurance","tag-health-insurance-card","tag-knowledge","tag-medical"],"_links":{"self":[{"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/posts\/2343","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/comments?post=2343"}],"version-history":[{"count":3,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/posts\/2343\/revisions"}],"predecessor-version":[{"id":2346,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/posts\/2343\/revisions\/2346"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/media\/694"}],"wp:attachment":[{"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/media?parent=2343"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/categories?post=2343"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/athenacorp.vn\/en\/wp-json\/wp\/v2\/tags?post=2343"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}