Editorial · January 5, 2019
Vietnam health insurance card: who needs one and how to use it
Vietnam health insurance card rules are simple at the top: under the Law on Health Insurance, taking part in the public health insurance scheme is compulsory for the groups the law names. The card is the proof that you are enrolled. It is what a hospital asks to see before it applies your insurance cover to the bill.
This guide explains who needs a card, what is on it, how to use it, and what to do when it expires or is lost. It is general information, not medical advice and not legal advice.
Who needs a Vietnam health insurance card
The Law on Health Insurance sets out the groups who take part. The first law, No. 25/2008/QH12, was passed by the National Assembly in 2008. A later amending law, No. 46/2014/QH13, changed several rules. The amending law took effect on 1 January 2015, and it widened and tightened who must take part, including families.
In practice, people join through different routes. Employees are enrolled through their employer, and the premium is shared between the worker and the company. The state pays for some groups, such as the poor, ethnic minority communities and young children. Students usually join through their school. Other residents join as individuals or as a household with the local social security office.
Under the amended law, the premium for a household is worked out by member. Later members of the same household pay a lower share than the first. Ask your local social security office for the exact rates that apply to you.
Foreign residents should ask before assuming anything. The rules for foreign staff and visitors are not the same as for citizens. Check with your employer, your local social security office, or the hospital.
What the card shows
Each card carries a code number that belongs to one person. It also shows the holder's name, date of birth and sex. It names the hospital or clinic where the holder has registered for first-line care. It shows the dates the card is valid.
The card also shows the group you belong to. That group decides how much of the bill the scheme pays. Most members get 80 percent of eligible costs covered. Some groups get a higher share, and some get the whole amount. The rest of the bill is paid by the patient.
Check your card the day you get it. A wrong birth date or a misspelled name can cause trouble later at the hospital desk. Ask the issuing office to fix errors right away.
How to use the card at a registered hospital
When you first enrol, you choose a facility for initial care. This is usually a local clinic, a commune health station, or a district hospital near your home or work. The choice is printed on your card. You can change it at set times, so ask the social security office when the next change period opens.
For normal care, go to that registered facility first. Take your card and a photo ID. The reception staff will check the card and the dates. If the doctor decides you need more advanced care, the facility writes a referral to a higher-level hospital. A patient who goes to a higher-level hospital with a referral is covered at the full rate for the card group. A patient who goes without a referral may be covered at a lower rate.
Emergencies are different. In an emergency, you may go to the nearest hospital, and the card still applies. Keep the receipts and the hospital papers. Staff can help you with the paperwork after the emergency has passed.
Not every private clinic accepts the card. Before a visit, ask whether the clinic is registered with the scheme. If it is not, you will pay the full bill yourself.
Renewing, replacing and correcting the card
A card is valid only for the period printed on it. Renew before the end date. If you pay as an individual or a household, go back to the social security office or the collection point and pay the new premium. If you are an employee, your employer normally handles the renewal. Ask your human resources team to confirm it.
A gap in cover can cost you. If your card runs out and you get care before you renew, the scheme will not pay for that visit. Set a reminder a month before the date.
If you lose the card, report it to the office that issued it and ask for a replacement. Bring your ID. If you change employer, move to another province, or want to change your first-line facility, tell the social security office so that the card record is updated.
Common mistakes to avoid
The first mistake is waiting until you are sick to look at the card. Check the dates and the registered facility now. The second is skipping the referral for a hospital stay, which can cut the share the scheme pays. The third is lending your card to someone else. The code belongs to one person, and misuse can lead to penalties.
A fourth mistake is assuming that the card covers everything. The scheme pays for eligible care at its set rates. Some items and services are outside it, and you pay for those. Ask the hospital desk what is covered before a planned treatment, and ask for a written estimate of what you will pay yourself.
Finally, keep a copy of the card and your premium receipts. If a dispute comes up, the receipts show that you paid and when.
The details above are general information, not medical advice. Rules and rates can differ by group and by province, so confirm them with your local social security office before you act.
Sources
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