Accordingly, cases that are covered by health insurance (HI) even if they do not have a card/hamlet card in Decree 188/2025/ND-CP include:
Children under 6 years old have not been issued health insurance cards
Clause 2, Article 37 (effective from 15-8-2025) stipulates: Children under 6 years old who have not been issued a health insurance card but have a birth certificate or birth certificate are entitled to undergo health insurance examination and treatment procedures and are fully paid by the health insurance fund within the scope of benefits of those with the card.
People waiting for reissuance, change or adjustment of card information
Clause 3, Article 37 clearly states: People waiting for reissuance, card exchange or information adjustment are allowed to use appointment papers issued by the Social Insurance agency and personal documents to check and treat health insurance and are paid according to their rights.
Emergency care, loss of consciousness or death have not yet presented a card
Clause 1, Article 54 (effective from 1-7-2025) stipulates: People who are unconscious, die or cannot present emergency cards will still be paid if the medical examination and treatment facility verifies the information about participating in health insurance.
People with a health insurance card are lost, damaged, have incorrect information but have not been adjusted
Also according to Clause 1, Article 54, people who have participated in health insurance but have lost their card, have incorrect information or have not updated it will still be paid after verifying the health insurance code correctly.
People in the group of people with state budget health insurance but have not been granted a card
Clause 1, Article 54 further stipulates: People whose names are on the list of health insurance participants paid by the state budget, even if they have not been granted a card, will still be paid for medical examination and treatment costs if confirmed by the Social Insurance agency.
