To:

- Social Security Offices of provinces or central-affiliated cities;
- Social Security Office of the Ministry of National Defence;
- Social Security Office of the Ministry of Public Security;
(hereinafter referred to as “provincial Social Security Offices")

On October 23, 2023, the Vietnam Social Security received Government’s Decree No. 75/2023/ND-CP dated October 19, 2023 on amendments to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government on elaboration of the Law on Health Insurance. To promptly implement Decree No. 75/2023/ND-CP, the Vietnam Social Security requests provincial Social Security Offices to carry out the following contents:

1. Issuance and replacement of health insurance cards under regulations of Decree No. 75/2023/ND-CP

1.1. Change in health insurance coverage rate code according to Clause 5 Article 1 of Decree No. 75/2023/ND-CP

- Regarding persons engaged in the resistance war for salvation of the Homeland (policyholder code: 1 “KC”) according to Clause 5 Article 3 of Decree No. 146/2018/ND-CP: changing health insurance coverage rate code from code 4 to code 2.

- Regarding home attendants of persons rendering meritorious revolutionary services (policyholder code: “PV”) according to Clause 19 Article 3 of Decree No. 146/2018/ND-CP 2: changing health insurance coverage rate code from code 4 to code 3.

1.2. Addition of policyholder code and health insurance coverage rate code stated in a health insurance card of a new health insurance policyholder according to Decree No. 75/2023/ND-CP and Decree No. 131/2021/ND-CP.

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- With regard to a martyr's wife or husband marrying another wife or husband who is on monthly benefits according to Point a Clause 10 Article 16 of Ordinance on preferential treatment given to people with meritorious services to the revolution: policyholder code: TG and insurance coverage code: 3; managerial group code: WG, statistical group code: 37.

- With regard to people in safe zone communes and revolutionary safe zones during the resistance war against the French and Americans and currently residing in safe zone communes during the resistance wars against the French and the Americans whose information have been updated in the National Population Database, Residence Database 4: policyholder code: AK and insurance coverage code: 2; managerial group code: WK, statistical group code: 61.

- Ethnic minorities who are living in communes of Region II, Region III, and extremely disadvantaged villages in ethnic minority and mountainous areas in the 2016-2020 period, but these communes are no longer on the list of communes in Region II, Region III, and extremely disadvantaged villages in ethnic minority and mountainous areas for the period 2021-2025 according to the Prime Minister's decision 5: policyholder code: DS and insurance coverage code: 3; managerial group code: WS, statistical group code: 62.

1.3. If a policyholder belongs to various categories of policyholders, the provincial social security office shall make review and compare the data which is being managed with that on policyholders stated in the application for change in coverage rate and the list of policyholders issued with new health insurance cards. In case the policyholder has been issued with a health insurance card applicable to policyholders whose insurance coverage rates are lower than those under new regulations, he/she will be entitled to the highest coverage rate.

2. Procedures for medical examination or treatment covered by health insurance according to Clause 6 Article 1 of Decree No. 75/2023/ND-CP:

When visiting healthcare establishments for medical examination or treatment services, health insurance policyholders must present photo health insurance cards or citizen identity cards; in case of absence of the photo, they shall be required to present one of their photo identity documents issued by competent bodies or authorities, or certificates endorsed by commune-level police authorities or others endorsed by educational institutions in charge of management of pupils or students; other legitimate personal identification documents or level-2 electronic identification (VneID) according to regulations of Decree No. 59/2022/ND-CP dated September 5, 2022 of the Government on electronic identification and authentication.

3. Payment for medical examination or treatment covered by health insurance in the transition period according to Article 4 of Decree No. 75/2023/ND-CP:

Health insurance policyholders who entered healthcare facilities for treatment before the effective date of this Decree but are discharged from the hospital on or after the effective date of this Decree will have their medical costs paid by the health insurance fund within their coverage scope and rates, in accordance with the Law on Health Insurance, Points b, c, d, dd, g, and h of Clause 1, Clauses 2, 3, 4, and 5 of Article 14 of Decree No. 146/2018/ND-CP , and Clause 5 of Article 1 of this Decree.

4. Implementation

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4.2. Information and Technology Centers shall assist provincial Social Security Offices in issuing health insurance cards and changing health insurance coverage rate codes according to guidance in this document.

For your information and compliance./.

PP. GENERAL DIRECTOR
DEPUTY GENERAL DIRECTOR




Nguyen Duc Hoa

1 1 Policyholder code under Decision No. 1351/QD-BHXH dated November 16, 2015 of General Director of Vietnam Social Security

2 2 This content is added by Point c Clause 1 Article 183 of Government’s Decree No. 131/2021/ND-CP dated December 30, 2021

3 3 This content is added by Point c Clause 1 Article 183 of Government’s Decree No. 131/2021/ND-CP dated December 30, 2021;

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5 5 According to regulations in Point c Clause 2 Article 1 of Decree No. 75/2023/ND-CP;