5 groups of insured persons who receive 100% medical expenses in 2024 are what groups?
Based on Clause 1 of Article 14 of Decree 146/2018 / ND-CP, Article 183 of Decree 131/2021 / ND-CP, there are 05 cases that are 100% medical expenses paid by health insurance.
– Group 1: the following subjects:
+ People with meritorious service to the revolution as prescribed in the Law on Preferential Treatment for People with Meritorious Services to the Revolution;
+ Veterans;
+ People entitled to monthly social protection allowances;
+ People in poor households; ethnic minorities living in economically and socially disadvantaged areas; people living in economically and socially difficult areas; people living in island communes, island districts and some other subjects under Clause 9 of Article 3 of Decree 146/2018 / ND-CP.
+ Relatives of martyrs include: fathers; birth mothers; wives or husbands, children of martyrs; people who have contributed to the care of martyrs;
+ People from 80 years old and above who receive monthly allowances.
– Group 2 – The following subjects are paid 100% medical examination and treatment costs and do not apply the rate of payment for drugs, chemicals, medical supplies and technical services:
+ People who participated in the revolution before January 1, 1945;
+ People who participated in the revolution from January 1, 1945 to the August Revolution in 1945;
– Mothers of Vietnam Hero mothers;
+ Disabled people, including grade B disabled soldiers recognized before December 31, 1993, people who enjoy policies like disabled soldiers with a disability rate of 81% or more;
+ Disabled soldiers with a disability rate of 81% or more;
+ People who have been exposed to toxic chemicals with a disability rate of 81% or more;
+ Disabled people, including grade B disabled soldiers recognized before December 31, 1993, people who enjoy policies like disabled soldiers, sick soldiers when treating wounds, diseases recurrence;
+ Children under 6 years old.
– Group 3: Participants in health insurance go to commune-level medical examination and treatment.
– Group 4: The cost for a medical examination and treatment is lower than 15% of the basic salary.
– Group 5: Having participated in health insurance for 5 consecutive years or more and having the amount of money equal to or greater than 6 months of basic salary for medical examination and treatment expenses during the year.
Note: Not applicable to cases of self-examination and treatment of illnesses not in the right direction.
Add 2 more cases where medical examination and treatment costs are 100% from 2024
Add 2 subjects 100% medical examination and treatment costs:
– People participating in the resistance war and defending the country;
– People in safe hamlets, safe revolutionary zones in the resistance war against France and the United States who currently reside in safe hamlets, revolutionary zones in the resistance war against France and the United States have been updated information in the National Population Database, the Database on Residence but not subject to the regulations of Clauses 1, 2, and 3, Article 12, Health Insurance Law.
In case a person belongs to multiple subjects entitled to benefits, how is the health insurance entitlement calculated?
Based on the provisions of Clause 2, Article 14 of Decree 146/2018 / ND-CP, if a person belongs to multiple subjects participating in health insurance, they are entitled to health insurance benefits according to the subject with the highest entitlement level.
