Health insurance (HI) is one of the pillars of social security to ensure that employees avoid and limit risks during work or when they are unfortunately unemployed.
Be paid 80% to 100% of medical examination and treatment costs
According to current regulations, employees with indefinite-term labor contracts (LTCs) or employees with a term of 1 month or more, even if employees and employers agree with another name but have content showing that the job has paid wages, salaries and the management, operation and supervision of one party is one of the subjects that must participate in compulsory health insurance.
Every month, employees must participate in employee health insurance and deduct a portion of employees' salary to contribute to the Health Insurance Fund along with the time of social insurance payment.
When fully participating in health insurance, employees will be examined and treated at medical facilities with health insurance examination and treatment contracts and will be covered by the Social Insurance agency for 80% to 100% of medical examination and treatment costs depending on the case.
According to Vietnam Social Insurance, every year, thousands of people are covered by the Health Insurance Fund for medical examination and treatment costs of over 1 billion VND, and some people are even covered by the Health Insurance Fund for medical examination and treatment costs of over 10 billion VND.
It is worth noting that if employees have participated in health insurance for 5 consecutive years (allowed for maximum interruption of 3 months) or more, they will enjoy higher benefits.
join household health insurance immediately so as not to interrupt benefits
The problem is, when employees unfortunately lose their jobs or terminate their labor contracts, how should they be handled so as not to lose their health insurance benefits.
According to current regulations, when an employee terminates the labor contract or employment contract but registers for unemployment and is eligible for unemployment benefits (TCTN) according to the provisions of the Law on Employment, during the period of receiving TCTN, the Social Insurance Fund will pay health insurance and health insurance benefits will be guaranteed normally.
Therefore, in case the employee is not eligible for TCTN or is on unpaid leave or temporarily postpones the employee's labor contract, it is necessary to participate in household health insurance immediately so as not to interrupt benefits. Because, according to current regulations, if you have participated in compulsory health insurance but not continuously for 90 days or more, the validity of the health insurance card will only arise after 30 days from the date of full health insurance payment.
Regarding the payment level, it is equal to 4.5% of the reference level (VND 2,340,000) and can be chosen as a 3-month, 6-month payment method or a one-time payment for the whole year. Depending on the number of members participating in household health insurance, the contribution level will be different, in the direction that the more people participate, the lower the contribution rate for those who are behind.
The first person's contribution rate is 100%, corresponding to 315,900 VND for a 3-month term, 631,800 VND for 6 months and 1,263,600 VND for 12 months. The second person will pay 70%, equivalent to 221,130 VND for a 3-month term, 442,260 VND for 6 months and 884,520 VND for 12 months.
The third person will pay 60%, equivalent to 189,540 VND for a 3-month term, 379,080 VND for 6 months and 758,160 VND for 12 months. The fourth person will pay 50%, equivalent to 157,950 VND for a 3-month term, 315,900 VND for 6 months and 631,800 VND for 12 months. The fifth person and above will pay 40%, equivalent to 126,360 VND for a 3-month term, 252,720 VND for 6 months and 505,440 VND for 12 months.
For near-poor households, the state will support 70% of health insurance payment costs, people only have to pay 30%. Accordingly, members of near-poor households will have the current health insurance contribution rate as follows (no deduction of the ratio according to the number of contributors): If paid for 3 months, people will pay 94,770 VND, the state will support 221,130 VND; paid for 6 months, people will pay 189,540 VND, the state will support 442,260 VND; paid for 12 months, people will pay 379,080 VND, the state will support 884,520 VND.
Lawyer Tran Phi Dai - Ho Chi Minh City Bar Association - recommends: "Health insurance is like a safety net, helping employees not to "fall straight to the ground" if they are unfortunately sick or have work accidents while working or when they lose their jobs. Therefore, employees need to participate fully in health insurance".
Conditions for receiving health insurance for 5 consecutive years
According to current regulations, the conditions for patients to receive health insurance for 5 consecutive years include: Having participated in health insurance for 5 consecutive years or more; Having the same amount of money to pay for medical examination and treatment costs in the year greater than 6 months of basic salary (currently equivalent to 14,040,000 VND); going to the right medical examination and treatment facility.
