A lot of Social Insurance and Health Insurance policies in effect from March 1, 2018

1. Cases in which one-off payment of social insurance coverage is made

The Circular No. 56/2017/TT-BYT prescribes the following illnesses of which cover for costs of treatment is paid on a lump-sum basis to insured employees:  

- Cancer, polio, cirrhotic ascites, leprosy, acute tuberculosis or HIV infection advanced to the AIDS stage which causes patients to be unable to control or perform walking, clothes dressing or personal hygiene and other daily routine activities and requires patients to be looked after by full-time caretakers. 

- Other illnesses or medical conditions other than the aforesaid which inflict at least 81% of work incapacity or impairment; and

Patients with these illnesses are unable to control or perform walking, clothes dressing or personal hygiene and other daily routine activities and need full-time caretakers. 

2. Instructions given to insured employees to complete medical assessment documentation to apply for their pension benefits

Also in this Circular, the Ministry of Health provides instructions for preparing medical assessment documentation to apply for their pension benefits as follows:

- As regards employees paying compulsory social insurance contribution: Letter of introduction issued by employers (using the sample given in the Appendix 1 attached to this Circular).

- As regards employees whose insurance contribution time interval is permitted or those who have already received an employment termination decision to be eligible for daily pension and insurance benefits: Request for medical assessment (using the sample given in the Appendix 2 attached to this Circular).

- Original or valid duplicate copies of one or more medical examination and treatment papers, including:

+ Medical condition summary, disability recognition certificate, hospital discharge certificate and health check-up information book;

+ Duplicate copy of occupational disease record, occupational disease or accident assessment report, required to be submitted by patients who have already undergone medical assessment of occupational diseases and accidents.

- One of the following photo-attached papers: ID card, Citizen Identification Card and Passport, all of which must remain valid (if not, Certificate which is issued by the commune-level Police with the photo on which an adjoining stamp is put within the maximum duration of 3 months till the time of submission of the medical assessment request must be presented).  
 
3. Modification of requirements for payment of HI coverage for medical services

This is the noticeable content of the Circular No. 50/2017/TT-BYT amending and supplementing regulations regarding payment of medical examination and treatment costs.

This Circular modifies one of requirements for payment of HI coverage for medical services referred to in subparagraph b paragraph 1 Article 3 of the Circular No. 35/2016/TT-BYT as follows:

With respect to medical services rendered according to professional procedures approved by competent authorities, the following modifications will be made: 

- A healthcare establishment is required to use its professional documents on diagnosis, treatment and technical procedures internally enforced by the Ministry of Health or Head of a healthcare establishment.  

- Head of a healthcare establishment issues professional instructions or technical procedures after consulting conventional documents which display scientific evidence and conform to fundamental conditions with respect to medical services which have not been published by the Ministry of Health.  

- Head of a healthcare establishment is responsible for sending published instructions or procedures to the Social Security department of a province where it is located.

4. Guidance on transfer of data on payment of costs of HI-covered healthcare services

The Circular No. 48/2017/TT-BYT prescribing selection and transfer of electronic data used for management and payment of HI-covered medical costs addresses protocols for transfer of electronic data, including:

- 1st protocol: Transfer carried out by using web service connections;

- 2nd protocol: Transfer carried out by synchronizing electronic data by using the server software;

- 3rd protocol: Transfer carried out by directly inputting data;

- 4th protocol: Transfer carried out by transmitting FTP (File Transfer Protocol) files.

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