Digital Convenience for the Five-Year Health Insurance Rule
The process of having treatment expenses covered by the fund for citizens who have had uninterrupted health insurance for five years and meet the specified conditions has been completely digitized.
While the health insurance participation rate across the province approaches 97%, administrative procedures for covering the treatment costs of individuals who have been insured for five consecutive years and meet certain conditions have been completely moved to a digital environment.
Insurance Participation Rate and Financial Support
The health insurance participation rate across the province has reached nearly 97%. In the first six months of the year, the cost of medical examinations and treatments covered by the fund exceeded 1.88 trillion VND, recording a 16.54% increase compared to the same period of the previous year. These data reveal that the insurance card provides significant financial security against illnesses.
Eligibility Conditions and Criteria
The expenses of individuals who have held health insurance for five years or more, receive treatment at designated facilities, and whose total annual co-payment exceeds 6 times the reference level are covered by the fund. To benefit from this right, it is necessary to accumulate regular contributions, reach the limit overrun, and comply with the referral system.
Facilitation of Processes Through Digital Transformation
Ngo Tuan Anh, Deputy Director of the Provincial Social Security Department, stated that this policy alleviates the financial burden on patients receiving long-term treatment. While patients previously had to keep receipts and apply in person, the procedure of submitting paper documents has been completely eliminated with the new system.
Electronic Data Interchange and Automated System
With Decree No. 188/2025/ND-CP, administrative procedures were simplified, transitioning to electronic data exchange. The system automatically calculates the co-payment amount, and it is sufficient for patients to simply present their cards or digital applications.
Premium Subsidies and Uninterruptedness Condition
With Resolution No. 17/2025/NQ-HĐND of the Provincial People's Council, additional premium subsidies ranging from 20% to 70% are provided to certain groups. For the five-year uninterrupted period to be considered valid, it is required that the premium interruption does not exceed 3 months.