The Government’s Decree 188/2025, which took effect on August 1st, outlines five scenarios where individuals without a health insurance card or those who haven’t presented their card are still eligible for reimbursement. These scenarios are as follows:

Children under 6 years old without a health insurance card can utilize their birth certificate or birth registration to access health insurance-covered medical examinations and treatments. The health insurance fund will bear the full cost within the scope of benefits, just like for cardholders.

Individuals awaiting the issuance, replacement, or information update of their card can use the appointment slip issued by the social insurance agency along with their identification documents to receive health insurance-covered medical services. Reimbursement will be made according to their respective benefits.

Illustration (Source: Thanh Hoa Provincial Portal)

Individuals requiring emergency treatment, unconscious, or deceased who haven’t presented their card are still eligible for reimbursement if the medical facility verifies their health insurance participation.

Individuals with a lost, damaged, or misinformed health insurance card can still receive reimbursement after their health insurance code is verified.

Individuals belonging to the group covered by state budget health insurance but have not yet been issued a card are still eligible for medical expense reimbursement upon confirmation from the social insurance agency.

Verification and Reimbursement Conditions

In the above cases, individuals need to:

Present their identification documents, birth certificate, appointment slip, or other relevant documents.

The medical facility and the social insurance agency must confirm the validity of the health insurance code.

Reimbursement will be made according to the corresponding health insurance entitlement of the individual.

According to the previous regulations outlined in Decree 146/2018, situations such as not having a card, losing a card, or having incorrect information on the card were not specifically addressed, leading to challenges in practical reimbursement approval.


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