Three cases where health insurance cards are not valid, everyone should know

What is a health insurance card?

Clause 1, Article 1 of the 2014 amended Law on Health Insurance stipulates that health insurance is a form of compulsory insurance organized and implemented by the State, applied to subjects prescribed by law for health care, not for profit purposes.

Health insurance is managed in 2 forms: compulsory health insurance (applicable to employees in enterprises, agencies, units; officials, civil servants, public employees; students, etc.) and voluntary health insurance (applicable to people who are not subject to compulsory health insurance).

According to Article 16 of the Law on Health Insurance 2008, health insurance cards are issued to health insurance participants and serve as a basis for enjoying health insurance benefits according to the provisions of this Law.

Each citizen participating in health insurance will be issued 01 health insurance card used as a basis to determine the health insurance benefits of the participant when going for health insurance examination and treatment according to regulations.

Currently, health insurance cards are issued according to the new model applied nationwide and have the confirmation stamp of the Social Insurance Agency where the card is issued.

According to regulations, when going to see a doctor or get treatment, you must present a valid health insurance card and a valid photo ID. For children under 6 years old, you must only present a valid health insurance card.

From June 1, 2021, people nationwide have been able to use the image of the health insurance card on the VssID social insurance application when going to see a doctor instead of using a paper insurance card. At the same time, health insurance medical examination and treatment facilities use a reader to scan the QR-code or directly record the health insurance card number on the VssID application in cases where the facility does not have a reader.

Regarding validity, based on the provisions of Clause 3, Article 16, Chapter III of the Law on Health Insurance (Law No. 25/2008/QH12, dated November 14, 2008), amending and supplementing a number of articles of Law No. 46/2014/QH13, dated June 13, 2014, for health insurance participants as prescribed in Clause 3, Article 50 of this Law who continuously pay health insurance from the second time onwards or health insurance participants as prescribed in Clause 2, Article 51 of this Law, the health insurance card is valid from the date of payment of health insurance.

For health insurance participants as prescribed in Clause 3, Article 50 of this Law who pay health insurance for the first time or pay health insurance intermittently, the health insurance card is valid after 30 days from the date of health insurance payment; for high-tech service benefits, the health insurance card is valid after 180 days from the date of health insurance payment.

For children under 6 years old, the health insurance card is valid until the child is 72 months old.

In case of emergency: You can be admitted to any medical examination and treatment facility and must present your health insurance card along with a valid identification document before being discharged from the hospital. If during the treatment, you discover and need to treat certain diseases, then treatment at the medical examination and treatment facility is considered to be in the right line.

In case of referral for treatment: Referral for technical expertise is allowed according to regulations in case the health insurance facility exceeds the treatment capacity or the technical services are not provided by the unit. The patient must present a valid health insurance card and a valid photo identification and a referral letter from the referring health insurance facility.

In case of payment for patient transportation costs: The subjects are "non-commissioned officers, people working in secretarial work...; People with meritorious services to the revolution; Relatives of people with meritorious services to the revolution (father, mother, child, people who raised martyrs); Children under 6 years old; People under monthly sponsorship;" the health insurance fund will pay for two-way transportation costs in case of technical transfer.

In case of re-examination: according to treatment requirements: Health insurance participants must have a re-examination appointment paper from the medical facility. The re-examination appointment paper is only used for one time of medical examination and treatment.

In case the health insurance card is not valid

The health insurance card is the basis for participants to enjoy health insurance benefits when receiving medical examination and treatment. However, the health insurance card will not be valid in the cases specified in Clause 4, Article 16, Law on Health Insurance 2008, amended and supplemented in 2014, including the following 3 cases:

(1) The card has expired. The validity period of the health insurance card depends on the participant and the time of payment of health insurance premium.

(2) The card is modified or erased.

(3) The person whose name is on the card does not continue to participate in health insurance.

If your health insurance card falls into one of the first two cases, you need to change to a new health insurance card to receive health insurance benefits according to regulations.

Minh Hoa (t/h)

Source