See now what is 5-year continuous health insurance, conditions for 5-year continuous health insurance, benefits of 5-year continuous health insurance, how to look up the value of using health insurance card?
What is 5-year continuous health insurance?
5 consecutive years of health insurance is understood as the insured person having paid for 5 consecutive years and the participant is only allowed to interrupt for a maximum of 3 months.
According to Decision 1666/QD-BHXH, the time of 5 consecutive years recorded on the health insurance card is specified as follows:
- In case of having paid health insurance for 5 consecutive years or more, as of January 1, 2015, the time recorded on the health insurance card is from January 1, 2015;
- In case you have not paid health insurance for 5 years or started paying health insurance for 5 consecutive years from January 1, 2015 onwards, the time recorded on the health insurance card is the first day of the 6th year.
For example:
As illustrated below, participants will have 5 consecutive years until February 1, 2027.
Conditions for receiving health insurance for 5 consecutive years
To receive benefits when participating in health insurance for 5 consecutive years, the insured person must meet the following conditions:
- Have paid health insurance for 5 consecutive years or more;
- The amount of money spent on co-payment of medical examination and treatment costs in the year is more than 6 months of basic salary (about 10,800,000 VND);
- Medical examination and treatment at the right place.
Note:
The co-payment amount or co-payment cost for medical examination and treatment is the amount that the patient with health insurance must pay to the social insurance agency according to the % rate of each type of card.
For example:
If your health insurance card covers 80% of the health insurance benefits, you will need to co-pay 20% of the total costs covered by health insurance.
See also:
>> Conditions for enjoying 100% health insurance for medical examination and treatment;
>> Latest basic salary.
Benefits of participating in health insurance for 5 consecutive years
Decree 146/2018/ND-CP guiding the Law on Health Insurance stipulates that health insurance participants will enjoy 100% of medical examination and treatment costs if they have participated in health insurance for 5 consecutive years or more.
Specifically:
➨ Case 1: If the co-payment amount for one or more medical examinations and treatments at the same medical facility is greater than 6 months of basic salary, you do not need to pay the co-payment amount greater than 6 months of your basic salary.
In this case, the medical facility must provide an invoice so that the patient has a basis to prove that the co-payment amount is enough for 6 months of basic salary and make a request for confirmation of no co-payment in that year to the social insurance agency.
➨ Case 2: The cumulative co-payment amount in the fiscal year at the same or different medical facilities is greater than 6 months of basic salary. In this case, the patient needs to do the following:
- Prepare documents to apply for a certificate of no co-payment during the year including:
- Health insurance card;
- Copy of CCCD/passport;
- Original hospital bill.
- Go to the Social Insurance agency that issued the health insurance card to request payment of the co-payment portion greater than 6 months of basic salary and receive a certificate of no co-payment in that year.
➨ Case 3: The co-payment amount exceeds 6 months of basic salary calculated from January 1, the Health Insurance Fund will pay 100% of the medical examination and treatment costs within the scope of the patient’s benefits from the time of full payment for 5 consecutive years until December 31 of that year.
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To renew your health insurance card in time and ensure your benefits when participating in health insurance for 5 consecutive years, you can look up the value of your health insurance card in the following ways:
- Look up health insurance card expiration date online on Vietnam Social Security website;
- Check health insurance card expiration date on VssID (electronic social insurance application);
- Check health insurance card expiration date via hotline or text message;
- Look up health insurance card expiration date using family health insurance payment receipt.
You can learn more about how to check the expiration date of your health insurance card in the article below:
>> How to check the expiration date of health insurance card.
Questions related to benefits when paying health insurance for 5 consecutive years
1. What is 5-year continuous health insurance?
5 consecutive years of health insurance is understood as the insured person paying for 5 consecutive years, with a maximum interruption of 3 months allowed.
2. Conditions for receiving health insurance for 5 consecutive years?
To enjoy health insurance benefits for 5 consecutive years, you need to meet the following conditions:
- Medical examination and treatment at the right place;
- Have paid health insurance for 5 consecutive years or more;
- The amount of money spent on co-payment of medical examination and treatment costs in the year is more than 6 months of basic salary.
>> See more: Conditions for receiving health insurance for 5 consecutive years.
3. What do you get with 5 consecutive years of health insurance?
People who participate in health insurance for 5 consecutive years will enjoy 100% of medical examination and treatment costs, according to 3 cases. You can refer to the details at:
>> Health insurance benefits for 5 consecutive years.
4. Regulations on how to record 5 consecutive years on health insurance card?
Vietnam Social Security stipulates how to record 5 consecutive years on the health insurance card as follows:
- In case of having paid health insurance for 5 consecutive years or more, as of January 1, 2015, the time recorded on the health insurance card is from January 1, 2015;
- In case you have not paid health insurance for 5 years or started paying health insurance for 5 consecutive years from January 1, 2015 onwards, the time recorded on the health insurance card is the first day of the 6th year.
5. Can I look up the expiration date of my health insurance card online?
Yes. You can easily check the validity period of your health insurance card online via the Vietnam Social Security Portal or the VssID application. Detailed instructions are shared by fdiinvietnam.com in the article:
>> How to look up the value of health insurance card.
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