MEDICAL INSURANCE TREATMENT

Health insurance medical examination and treatment process: Fast and convenient at Hospital 199

Health insurance medical examination and treatment procedures are the steps that health insurance participants must take...

09
Jan
Health insurance benefits: What do you need to know when visiting Hospital 199?

Health insurance medical examinations and treatments (BHYT) have become an important method for ensuring the...

09
Jan

Insurance Benefits

  1. Illness Benefits

    • Leave ranging from 30 to 180 days, depending on the duration of social insurance contributions and the nature of the job.
    • Receive a benefit equal to 75% of the most recent monthly salary, decreasing based on the duration of social insurance contributions.

  2. Maternity and Childbirth Benefits

    • Leave for prenatal checkups, childbirth, or contraception for the prescribed duration.
    • Receive maternity benefits equal to six months of average salary and a one-time benefit equivalent to two months of basic salary.

  3. Occupational Accident and Disease Benefits

    • Receive benefits based on the degree of work impairment (5% and above).
    • Benefits are provided monthly or as a one-time payment, depending on the degree of disability.

  4. Retirement benefits

    • Receive monthly pension (maximum 75% of average salary).
    • One-time allowance if benefit level exceeds 75%.

  5. Death benefits

    • Funeral allowance (10 times base salary).
    • Relatives receive a monthly allowance (50-70% of base salary) or a one-time allowance depending on conditions.

  6. Withdraw social insurance one time

    • People who do not want to continue participating can withdraw social insurance, but it is not recommended because it affects long-term benefits.

Health insurance benefits

1. Support for Medical Examination and Treatment Expenses

Health Insurance participants are supported to cover part or all of the costs of medical examinations and treatments at public healthcare facilities or private establishments that have contracts with Health Insurance for medical services.

  • The reimbursement rate typically ranges from 80% to 100%, depending on the participant category.
  • For special cases (such as impoverished households, children under 6 years old, and elderly individuals), Health Insurance may cover the entire cost.

2. Regular and Emergency Medical Examinations and Treatments

Health Insurance ensures the right to medical examinations and treatments in both emergency situations and regular check-ups. Patients can receive treatment at any healthcare facility that has a Health Insurance contract, regardless of their initial registration location in emergency situations.

3. Support for Medication and Medical Supplies Costs

Health Insurance participants are supported for the costs of medications, medical supplies, and high-technology services as listed and approved by the Ministry of Health.

  • This list is regularly updated to align with treatment needs and actual conditions.

4. Medical Care for Critical or Chronic Illnesses

  • Individuals with critical illnesses (such as cancer, chronic kidney disease, etc.) or chronic diseases requiring long-term treatment are supported by Health Insurance for a significant portion of the costs.
  • Diseases requiring high-technology treatments or the use of expensive equipment (such as heart surgery, organ transplants, radiotherapy) are also reimbursed by Health Insurance according to the prescribed rates.

 

FREQUENTLY ASKED QUESTIONS

Answer:

Health Insurance (BHYT) applies to all categories as prescribed by law, including:

  • Employees with labor contracts of three months or more.
  • Students.
  • Households voluntarily participating in BHYT.
  • Social policy groups (impoverished households, children under six years old, elderly individuals, people who have contributed to the revolution, etc.).

Answer:

  • Employees: Contribute 4.5% of their monthly salary (of which the employee contributes 1.5% and the employer contributes 3%).
  • Students: Contribute approximately 70% of the regulated amount (the remaining 30% is supported by the government).
  • Households: The contribution rate decreases based on the number of members:
    • First member: Contribute 4.5% of the base salary.
    • Second member: 70% of the first member’s contribution.
    • Third member: 60% of the first member’s contribution.

Answer:

  • Health Insurance Participants: Must register for initial medical examinations and treatments at public healthcare facilities or designated hospitals.

  • Emergency Cases: Patients can receive medical examinations and treatments at any healthcare facility that has a signed contract for Health Insurance services.

  • Out-of-Network Treatments: Medical examinations and treatments outside the designated network are still supported but at a lower rate.

Answer:

Support for Out-of-Network/Over-Network Medical Examinations and Treatments for Health Insurance Participants:

  • Central Level: Covers 40% of inpatient costs.
  • Provincial Level: Covers 100% of inpatient costs.
  • District Level: Covers 100% of costs without the need for a referral.

Answer:

Depending on the category of individuals and the type of Health Insurance:

  • Certain groups (children under 6 years old, low-income households, elderly individuals) may have their costs fully covered.
  • Other cases are usually covered from 80% to 95% of the costs.

Answer:

Health Insurance-Covered Medication List: Regulated by the Ministry of Health and regularly updated. This list includes:

  • Medications for the treatment of common diseases.
  • Medications for the treatment of chronic and severe illnesses (such as cancer and diabetes).
  • Medical supplies and high-tech services.

Answer:

Children under 6 years old are provided with free Health Insurance (BHYT).When seeking medical examinations and treatments, parents need to bring the Health Insurance card and the child’s birth certificate.

Answer:

You can look up Health Insurance (BHYT) information through:

  • The Vietnam Social Insurance website.
  • The VssID application.
  • By calling the Vietnam Social Insurance support hotline.