[HEALTH LAW ARTICLE]

Besides social insurance, health insurance is an important policy and closely related to people's health. In 2021, regulations on health insurance have many changes. One of them is the change in benefits of health insurance participants for 5 consecutive years. So, what are the special benefits for people who have 5 consecutive years of health insurance card? The following article of Medlaw will help you answer this question!

What is 5-year continuous health insurance?

According to Article 12 of Decree 146/2018/ND-CP, the health insurance card will determine the full 5-year period of the health insurance participants. In which, the period of continuous participation in health insurance is the period of use indicated on the next health insurance card following the previous one; the maximum interruption is not more than 03 months. On the other hand, according to Clause 1, Article 3 of Decision 1666/QD-BHXH stipulates, for people participating in health insurance for 5 consecutive years, the end of the health insurance card will have the words "Time of full 05 consecutive years: From date …./…/…..”. 

Special benefits when participate in health insurance for 5 consecutive years 

Pursuant to Clause 15, Article 1 of the Law on Health Insurance, amended and supplemented in 2014, Point dd, Clause 1, Article 14 and Clause 3, Article 27 of Decree 146/2018/ND-CP, for those who already have health insurance consecutive years or more, their benefits are greatly enhanced. As follows:

– Patients are paid 100% of medical examination and treatment expenses by the health insurance fund within the scope of their entitlement if they have participated in health insurance for 5 consecutive years or more and have the same amount of money to pay for medical examination and treatment expenses. , medical treatment in a year is more than 6 months' basic salary, except for cases of self-examination and medical treatment at the wrong line. The above regulation can be understood as the case where the insured person has participated in health insurance for 5 consecutive years or more and has a co-pay for medical examination and treatment expenses in a calendar year which is greater than 6 months' basic salary. Currently, it is 8,940,000 VND) when going for medical examination and treatment (at the right level), the next medical examination and treatment in the year will be entitled to 100% of medical examination and treatment costs within the scope of health insurance coverage (except for the case of self-examination, medical examination and treatment). incorrect treatment).

In addition, people will be granted a “Certificate of non-co-payment in the year” and enjoy 100% of medical expenses covered by health insurance for the next medical examination and treatment.

– When being granted this certificate, people will not have to pay a co-pay of 5% or 20% of medical examination and treatment costs (currently, when going to medical examination and treatment at the right level, most patients can only pay 95% or 80% of the cost within the scope of benefit).

It can be seen that health insurance is especially important in reducing the financial burden for patients, especially for those who have had health insurance for 5 consecutive years.