Chương I Nghị định 146/2018/NĐ-CP: Đối tượng tham gia bảo hiểm y tế

Chapter I

PERSONS ELIGIBLE TO PARTICIPATE IN HEALTH INSURANCE

Article 1. Group of health insurance policyholders whose contributions are paid by both employees and employers

1. Employees working under indefinite-term employment contracts or fixed-term employment contracts, each of which has the term of at least 3 months; managers of enterprises, non-state public service providers, managers or administrators of cooperatives who are entitled to wages or salaries; public officials, servants and employees.

2. Lay public officers at communes, wards and townlets in accordance with laws.

Article 2. Group of health insurance policyholders whose contributions are paid by social insurance agencies

1. Persons eligible to be entitled to retirement pensions and incapacity benefits

2. Persons currently entitled to monthly social insurance benefits in connection with occupational accidents or diseases; rubber plantation workers currently entitled to monthly benefits in accordance with the Government’s regulations.

3. Employees on sick leaves in connection with diseases defined in the List of diseases of which long-term treatments are required, issued by the Ministry of Health.

4. Public officers of communes, wards or townlets who leave work and are currently entitled to monthly social insurance benefits.

5. Employees on parental leaves who are entitled to childbirth and adoption benefits.

6. Persons currently entitled to unemployment benefits.

Article 3. Group of health insurance policyholders whose contributions are paid by the state budget

1. Public officers of communes, wards or townlets who leave work and are currently entitled to monthly social insurance benefits financed by the state budget.

2. Persons already terminating entitlement to incapacity benefits who are currently entitled to monthly benefits financed by the state budget.

3. Persons rendering meritorious revolutionary services under the provisions of the Ordinance on preference treatment for persons rendering meritorious revolutionary services.

4. War veterans, including:

a) Veterans who participated in resistance wars from April 30, 1975 backwards according to the provisions of clauses 1, 2, 3 and 4, Article 2 of the Government's Decree No. 150/2006/ND-CP dated December 12, 2006, detailing and guiding the implementation of a number of articles of the Ordinance on Veterans (hereinafter referred to as Decree No. 150/2006/ND-CP), which was amended and supplemented in clause 1, Article 1 of the Government’s Decree No. 157/2016/ND-CP dated November 24, 2016, amending and supplementing the Government's Decree No. 150/2006/ND-CP dated December 12, 2006, detailing and guiding the implementation of certain Articles of the Ordinance on Veterans (hereinafter referred to as Decree No. 157/2016/ND-CP).

b) Veterans who participated in resistance wars after April 30, 1975 according to the provisions of clause 5, Article 2 of the Government's Decree No. 150/2006/ND-CP dated December 12, 2006, detailing and guiding the implementation of a number of articles of the Ordinance on Veterans and clause 1, Article 1 of the Government’s Decree No. 157/2016/ND-CP dated November 24, 2016, amending and supplementing the Government's Decree No. 150/2006/ND-CP, including:

- Servicemen and national defense workers already entitled to benefits under the Prime Minister's Decision No. 62/2011/QD-TTg of November 9, 2011 on compensation regimes and policies for persons participating in national protection wars, sent on international missions in Cambodia, and giving friendship supports to Laos after April 30, 1975, who have already retired, been demobilized or resigned (hereafter referred to as Decision No. 62/2011/QD-TTg);

- Officers, professional servicemen, non-commissioned officers, soldiers and national defense workers directly participating in the national defense war, dispatched on international missions in Cambodia and giving friendship supports to Laos after April 30, 1975, who are now, depending on their respective specialty, working at agencies, organizations and enterprises (not entitled to benefits under the Decision No. 62/2011 / QD-TTg);

- Officers and professional servicemen already fulfilled their active military service obligations in the period of building and defending the Fatherland, who have been demobilized, retired or transferred to agencies, organizations and enterprises;

- Militia and self-defense force members engaged in combats or directly rendering combat services after April 30, 1975, who have been entitled to benefits under the Decision No. 62/2011/QD-TTg.

5. Persons engaged in the resistance war and protecting the Fatherland, including:

a) Persons fighting the war against the US for protection of the Motherland who have been granted benefits under one of the following documents:

- Prime Minister’s Decision No. 290/2005/QD-TTg dated November 1, 2005 on compensation regimes and policies for certain persons directly fighting the anti-US resistance war who have yet to be awarded compensation treatment from the Communist Party and Government of Vietnam;

- Prime Minister’s Decision No. 188/2007/QD-TTg dated December 6, 2007 on amendments to Prime Minister’s Decision No. 290/2005/QD-TTg dated November 1, 2005 on compensation regimes and policies for certain persons directly fighting the anti-US resistance war who have yet to be awarded compensation treatment from the Communist Party and Government of Vietnam;

- Prime Minister’s Decision No. 142/2008/QD-TTg dated October 27, 2008 on implementation of compensation regimes for servicemen involved in the anti-US resistance war for national salvation who have had less than 20 years working in the army and are now demobilized and discharged from the military to return to localities;

b) Persons who have already been entitled to benefits under the Decision No. 62/2011/QD-TTg but are not veterans as stipulated in clause 4 of this Article;

c) Officers and soldiers of the People's Police participating in the anti-US resistance war for national salvation who have less than 20 years working in the People's Police, who have resigned or returned from the People's Police to their localities and have been entitled to benefits under the Prime Minister's Decision No. 53/2010/QD-TTg dated August 20, 2010 on compensation regimes for officers and soldiers of the People's Police participating in the anti-US resistance war for national salvation who have less than 20 years working in the People's Police, and currently resign and return to their localities;

d) Young volunteers who have been provided with benefits according to the Prime Minister's Decision No. 170/2008/QD-TTg dated December 18, 2008 on health insurance, funeral and burial benefits for young volunteers involved in the resistance war against France, the Decision No. 40/2011/QD-TTg dated July 27, 2011 regulating compensation regimes for young volunteers who have completed their duties in the resistance war and the Government’s Decree No. 112/2017/ND-CP dated October 6, 2017 providing for compensation regimes and policies applicable to young volunteers in the military base in the South who were involved in the resistance war during the 1965 – 1975 period;

dd) Frontline non-combat soldiers participating in the resistance war against France, against the US or the Fatherland protection war and sent on international missions who have been entitled to benefits under the Prime Minister's Decision No. 49/2015/QD-TTg dated October 14, 2015 on a number of compensation regimes and policies for frontline non-combat soldiers involved in the resistance war against France, against the United States, the war for protection of the Fatherland, or sent on international missions.

6. Incumbent National Assembly deputies and incumbent members of all-level People’s Councils.

7. Children under 6 years of age.

8. Persons eligible to be entitled to monthly social protection benefits under laws on the elderly, the disabled and subject of social protection programs.

9. Members of poor households; ethnic minority people living in areas with difficult socio-economic conditions; people living in areas with extremely difficult socio-economic conditions; persons living in island communes or districts and some other subjects, specifically including:

a) Members of poor family households defined according to the classification criteria regarding incomes, members of multi-dimensional poor households that have a shortage of health insurance as stipulated in the Prime Minister's Decision No. 59/2015/QD-TTg dated November 19, 2015 promulgating the multi-dimensional poverty approach for the period of 2016-2020 and other decisions of competent authorities to amend, supplement or replace the poverty line applied over periods of time;

b) Ethnics living in areas with difficult socio-economic conditions under the regulations adopted by the Government and the Prime Minister;

c) Inhabitants living in areas with extremely difficult socio-economic conditions under the regulations adopted by the Government and the Prime Minister;

d) Residents living in island communes or districts in accordance with regulations of the Government and the Prime Minister.

10. Persons who are awarded the title of People’s artisans or outstanding artisans living in families earning the monthly income per capita lower than the base pay regulated by the Government.

11. Relatives of persons rendering meritorious revolutionary services who are natural parents, spouses or children of revolutionary martyrs; persons providing accommodations for martyrs.

12. Relatives of persons rendering meritorious revolutionary services, except those defined in clause 11 of this Article, including:

a) Natural parents, spouses, children aged from over 6 years to under 18 years, or 18 years or older if they are still going to school or are suffering serious disabilities or extremely serious disabilities, of the followings: Revolutionaries carrying out activities before January 1, 1945; revolutionaries carrying out activities from January 1, 1945 to the August Uprising in 1945; heroes of the People’s Armed Forces and heroes of labor in the resistance war stage; wounded soldiers and sick soldiers suffering a reduction by 61% and more of their labor capacity; partisans infected with toxic chemicals whose labor capacity is reduced by at least 61%.

b) Natural children aged 6 years or older of partisans exposed to toxic chemicals causing deformities and disabilities due to consequences thereof, unable to be self-reliant in performing everyday life activities or suffering from reductions in capabilities for self-reliance in everyday life activities, who are entitled to monthly benefits.

13. Relatives of officers, professional servicemen, non-commissioned officers and military soldiers in active service, administrative officers, non-commissioned officers and technical or engineering officers, non-commissioned officers in the people’s public security forces, trainees of the people’s police, non-commissioned officers and cryptographic officers who are paid salaries as servicemen, cryptographic trainees entitled to the same compensation regimes and policies as trainees of military and police education institutions, including:

a) Natural parents; natural parents-in-law; legal caregivers of selves and spouses;

b) Spouses;

c) Natural children or legally adopted children aged from 6 years to under 18 years; natural children and legally adopted children aged 18 years or older if they are still taking formal education.

14. Persons already donating human body organs under laws on organ donation and transplantation.

15. Foreigners studying in Vietnam who receive scholarships financed by the state budget of Vietnam.

16. Home attendants of persons rendering meritorious revolutionary services, including:

a) Attendants of Vietnamese heroic mothers;

b) Attendants of wounded soldiers, sick soldiers who suffer from a reduction by at least 81% of labor capacity;

c) Attendants of partisans suffering diseases due to exposure to toxic chemicals whose labor capacity is reduced by at least 81%.

17. Persons aged 80 years or older who are entitled to monthly benefits for elderly people under laws on social insurance.

Article 4. Group of health insurance policyholders whose contributions are supported by the state budget

1. Members of near-poor family households defined according to the near-poor criteria under regulations of the Government and the Prime Minister.

2. Members of multidimensional-poverty family households falling into the cases specified in point a, clause 9, Article 3 hereof.

3. Pupils and students.

4. Members of family households doing business in the agriculture, forestry, aquaculture and salt industry who earn an average income in accordance with regulations of the Government and the Prime Minister.

Article 5. Group of family-based health insurance policyholders

1. Persons whose names are inscribed in family household records, except those subjects specified in Article 1, 2, 3, 4 and 6 hereof.

2. Persons whose names are inscribed in temporary residence records, except those specified in Article 1, 2, 3, 4 and 6 hereof and those already participating in health insurance as prescribed in clause 1 of this Article.

3. The following persons eligible for family-based participation in health insurance:

a) Dignitaries, sub-dignitaries and clergy;

b) Persons residing in social relief establishments, except for those defined in Articles 1, 2, 3, 4 and 6 hereof without health insurance contributions supported by the state budget.

Article 6. Group of health insurance policyholders whose contributions are paid by employees

1. Relatives of public national defense workers and employees on active service in the military, including those defined in point a, b and c, clause 13, Article 3 hereof.

2. Relatives of public security workers on active service in the People’s Police, including those defined in point a, b and c, clause 13, Article 3 hereof.

3. Relatives of those performing other tasks in cryptographic organizations, including those defined in point a, b and c, clause 13, Article 3 hereof.