Chương III Nghị định 146/2018/NĐ-CP: Thẻ bảo hiểm y tế

Chapter III

HEALTH INSURANCE CARDS

Article 11. Preparation of list of policyholders awarded health insurance cards

1. Employers shall prepare the list of policyholders belonging in the group of policyholders prescribed in Article 1 hereof.

2. Educational institutions and vocational education establishments shall be responsible for preparing the list of policyholders in the group under their jurisdiction as provided in clause 15 of Article 3 and clause 3 of Article 4 hereof.

3. Affiliates of the Ministry of National Defence or the Ministry of Public Security shall be responsible for compiling the list of policyholders belonging in the group under their management as provided in clause 1 of Article 1 and clause 13 of Article 3 and Article 6 hereof and under the instructions of the Ministry of National Defence or the Ministry of Public Security.

4. As regards any policyholder who donates his/her organs under laws, social insurance agencies shall consult his/her hospital discharge form, issued by the healthcare establishment where he/she donates his/her organs, in order to issue the health insurance card.

5. Commune-level People’s Committees shall be responsible for compiling the list of policyholders referred to in Article 2; clause 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 16 and 17 of Article 3; clause 1, 2 and 4 of Article 4 and Article 5 hereof.

6. The list of health insurance policyholders shall be prepared by using the Form No. 2 and No.3 of the Appendices to this Decree.

Article 12. Health insurance cards

Health insurance cards shall be issued by competent social insurance agencies and contain the following information:

1. Personal information of a policyholder, including full name, gender, date of birth, permanent residence or workplace address.

2. Health insurance coverage rate stipulated in Article 14 hereof.

3. Start date of a health insurance card.

4. Name of the primary healthcare establishment.

5. The consecutive 5-year or longer period of health insurance participation of policyholders making co-payment of healthcare costs. The consecutive period of health insurance participation refers to the date subsequent to the previous date of issue inscribed on a health insurance card; in case of an interval, it must be less than 03 months.

With respect to persons dispatched by competent authorities to go on an educational or business trip; spouses, natural children, or legally adopted children aged under 18 years, accompanying their parents serving terms of office at Vietnam’s overseas missions, their overseas stay period shall be accepted as the period of health insurance participation.

With respect to employees working abroad, the period of their health insurance participation before their overseas work shall be assumed as the period of health insurance participation if they resume participating in the health insurance within duration of 30 days from the date of their entry.

If employees await completion of required procedures for entitlement to unemployment benefits as provided by the Law on Employment, the period of the previous health insurance participation shall be assumed as the period of health insurance participation.

With respect to policyholders, referred to in point a of clause 3 of Article 12 of the Law on Health Insurance, who retire, are demobilized, transfer to other business or resign, if they have not yet participated in the health insurance during the period of their study or military service in the people’s army, the people’s public security force or a cryptographic body, that period shall be assumed as the consecutive period of health insurance participation.

6. Photo of the policyholder (not applicable to children under 6 years of age) in case where he/she does not have any photo personal identification document issued by competent bodies or authorities, or any certificate issued by commune-level police authorities or other documents endorsed by educational institutions or vocational education establishments in charge of management of pupils or students, or other legitimate personal identity documents.

Article 13. Validity period of health insurance cards

1. With respect to policyholders specified in clause 6 of Article 2, health insurance cards shall have validity from the first month of entitlement to unemployment benefits which is determined in the decision on entitlement to unemployment benefits, issued by a competent regulatory authority.

2. With regard to policyholders specified in clause 7 of Article 3 hereof:

a) If a child is born before September 30, his/her health insurance card shall be valid until the end of September 30 of the year in which he/she reaches 72 months of age;

b) If a child is born after September 30, his/her health insurance card shall be valid until the end of the last date of the month in which he/she reaches 72 months of age.

3. With respect to policyholders referred to in clause 8 of Article 3 hereof, their health insurance cards shall be valid from the date of social welfare entitlement determined in the decision issued by the district-level People’s Committee.

4. With respect to the policyholders specified in clause 9 of Article 3, or the policyholders prescribed in clause 1 of Article 4 hereof, if their health insurance contributions are wholly supported by the state budget, their health insurance cards shall be valid from the date specified in the decision on approval of the list of policyholders, issued by a competent authority.

5. With respect to the policyholders specified in clause 10 of Article 3 hereof, their health insurance cards shall be valid from the date specified on the decision on approval of the list of policyholders, issued by a competent authority.

6. With respect to the policyholders specified in clause 14 of Article 3 hereof, their health insurance cards shall be valid immediately after the date of donation of their organs.

7. With regard to policyholders specified in clause 3 of Article 4 hereof:

a) Health insurance cards shall be annually issued to students at general education institutions, including the following cases:

- As regards 1^st - grade pupils, each health insurance card shall be valid from the 1^st day of October of the first year of elementary education;

- As regards12^th - grade students, each health insurance card shall be valid till the end of September 30 of that school year.

b) Each health insurance card shall be annually issued to pupils and students at higher education establishments and vocational training facilities, including the following cases:

- As regards first-year students of academic programs, each health insurance card shall be valid from the first date of the academic year, except the case in which 12^th - grade students hold their health insurance cards remaining valid;

- As regards last-year students of academic programs, each health insurance card shall be valid till the last date of the final month of each academic program.

8. With regard to others, each health insurance card shall be valid from the first date of payment of health insurance contribution. If the policyholders referred to in clause 4 of Article 4, Article 5 and 6 hereof participate in the health insurance for the first time or do not incessantly participate in the health insurance for at least 3 months in a financial year, each health insurance card shall have the validity period of 12 months from the date on which it is in effect as per point c of clause 3 of Article 16 in the Law on Health Insurance.

9. The validity of each health insurance card as prescribed in this Article shall be equivalent to the amount of health insurance contribution in accordance with regulations in force, except policyholders who are children under 6 years of age.