Circular 41/2014/ttlt-Byt-Btc: Guide The Implementation Of Medical Insurance

Original Language Title: Thông tư liên tịch 41/2014/TTLT-BYT-BTC: Hướng dẫn thực hiện bảo hiểm y tế

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CIRCULAR Guide make health insurance _ _ _ _ _ _ _ _ _ _ _ _ _ _ pursuant to the law on health insurance of 14 November 2008 and the law amending and supplementing some articles of the law on health insurance of 13/6/2014;
Pursuant to Decree No. 105/2014/ND-CP on November 15, 2014 the Government detailing and guiding the implementation of some articles of the law on health insurance;
Pursuant to Decree No. 63/2012/ND-CP on August 31, 2012 of the Government functions, tasks, powers and organizational structure of the Ministry of health;
Pursuant to Decree No. 215/2013/ND-CP on December 23, 2013 of government functions, tasks, powers and organizational structure of the Ministry of finance;
The Minister of health, the Minister of Finance issued circular guidelines for health insurance.
Chapter I OBJECT to JOIN the CLOSED METHOD, and the RESPONSIBILITIES of medical INSURANCE PREMIUMS article 1. Audience participation for health insurance under the provisions in article 12 amendments, supplements of the law on health insurance; articles 15, 21, 25 and 26 additional amendments of the Ordinance on the incentive people to the revolution and article 1 of Decree 105/2014/ND-CP, engaged audience of health insurance (hereinafter abbreviated as HEALTH INSURANCE) includes: 1. Group by the workers and the employers to close , including: a) the employees working under employment contract does not specify the duration, employment contract term from 3 months enough; Business Manager, business units outside of the establishment and the Executive management are entitled to salary cooperatives; public servants (hereinafter referred to as workers) work at the Agency, organization, enterprises:-State Agency, the people's armed units;
-Political organization, social-political organizations, social-political organizations, social organizations, social-professional organizations, other social organizations;
-Business units and non-public;
-Businesses in the economic sectors was established, operating under the enterprise law, investment law;
-Agency, foreign organizations, international organizations active on the territory of Vietnam;
-Cooperative, the cooperative established Nations, operating under the law on cooperatives;
-Individual business households, group collaboration, other organizations and individuals are hiring workers under employment contracts.
b) Who are dedicated to operations in the communes, wards and towns in accordance with the law.
2. Group by social insurance institutions, including: a) who enjoy pensions, grants monthly labour power loss;
b) who are entitled to social insurance subsidies, due to constant labour accident, occupational disease or illness in the category of diseases need longer treatment; people from 80 years of monthly dog voucher;
c) officer, Ward, the town was the holiday voucher monthly social insurance;
d) who are entitled to unemployment benefit;
DD) rubber workers are entitled to monthly allowance by decision No. 206/CP 30/5/1979 of the Government Council (the present Government) about the policy for new workers clearing the hard line of work harmful to health, now ill have to resign.
3. Group by closing state budget, include: a) officer, professional soldier, officer down, army troops are active; the lower officers, officers and professional officers of the lower officers, technical expertise, are the work of the people's public security forces, students of public security of the people, the lower officers, soldiers served in duration public security people; who do the work as paid body for military personnel; the student body enjoy mode, policy regimes, policy for students in the military field, public safety;
b) officer, Ward, the commune has monthly voucher from the State budget;
c) who only support lost labor monthly voucher from the State budget;
d) people to the revolution, veterans, including:-people revolution in accordance with Ordinance on incentive people to the revolution;
-Veteran joined the resistance from 30/4/1975 and earlier under Article 6, paragraph 5 of Decree 152/2006/ND-CP dated 12 December 2006 from the Government detailing and guiding the implementation of some articles of the Ordinance on war veterans;
-People directly involved in the resistance against the US save the country but have yet to enjoy the party and State's policy decision No. 289/2005/QD-TTg dated 08/11/2005 by the Prime Minister of the regime, the policy for a number of objects to directly join the war to save the country but have yet to enjoy the party and State's policy and decision No 188/2007/QD-TTg dated 06/12/ 2007 by the Prime Minister about the amendments and supplements of decision No. 289/2005/QD-TTg;
-Officer police, soldiers join the resistance against the people of America have under 20 years working in public security people were quitting, demobilized on local decision 53/2009/QD-TTg on 20/8/2010 of the Prime mode for officers, the people's public security soldiers join the resistance against the Americans have under 20 years working in public security people have work, demobilized on local;
-Military personnel join the war to save the country has under 20 years in the army, was serving, demobilized on local decision No. 142/2008/QD-TTg on October 27, 2008 by the Prime Minister on the implementation of the regime for military personnel to join the resistance against the US save the country has less than 20 years of work in the army , have demobilized, serving on local and decision No. 38/2009/QD-TTg on 6/5/2010 of the Prime Minister about the amendments and supplements of decision No. 142/2008/QD-TTg;
-Participants of war defense, international duty in Cambodian, Lao helps you later on 30/4/1975 has served member, discharge, retrenchment by decision No. 62/2011/QD-TTg on 04/11/2011 of the Prime Minister of the regime, the policy for participants of war defense , international duty in Cambodian, Lao helps you later on 30/4/1975 has served member, discharge, retrenchment;
-Youth volunteer by decision No. 170/2008/QD-TTg dated 18/12/2008 by the Prime Minister on the HEALTH INSURANCE regime and funeral expenses allowance for youth volunteer period resistance against France and decision No. 40/2009/QD-TTg on 27/7/2011 Prime's regulations on the regime for youth volunteer has completed the task during the Vietnam war.
DD) deputies, deputies to the people's Council the current level;
e) children under 6 years (including the entire children of local residents, including children as relatives of the object specified in point a of this paragraph, irrespective of permanent residence);
g) a social assistance allowance, constant made under the provisions of Decree 136/2013/ND-CP dated 21/10/2013 of government regulation of social assistance policy for social protection object, Decree No. 6/2010/ND-CP on 14/01/2011 the Government detailing and guiding the implementation of some articles of the law on the elderly and Conference No. 28/2012/NĐ-CP on 10/4/2012 of the Government detailing and guiding the implementation of some articles of the law on people with disabilities;
h) who belonged to poor households; the ethnic minorities are living in regions with socio-economic difficulties; people are living in regions with socio-economic conditions particularly difficult; people are living in the island Township, district of the island under the resolution of the Government, the Prime Minister's decision and the decision of the Secretary, the Chairman of the Committee;
I) relatives of people with the revolution as the father, mother, wife or husband, son of the martyr; people nourish the martyr;
k) relatives of people with the revolution, except the objects specified in point i, comprises:-the father, mother, wife or husband, children from 6 years old to under 18 years of age on or from 18 years of age if still continue to go to school or have a disability, special disabled by heavy objects : The revolutionary activities before 01/01/1945; the revolutionary activity from 01/01/1945 to August 1945 uprising; Hero of the people's armed forces, hero of Labor during the period of resistance; the wounded soldiers, reduced the ability of labor from 61%; active people infected resistance chemical toxins deterioration of labor from 61%;
-A child from the age of 6 who works on resistance infected with chemical toxins, deformities as a result of chemical toxins not self was in living or decline in self-reliance activities.
l) relative of the objects specified in point a of Paragraph 3 of this article (except a child, adopted child under 6 years old);
m) who have donated human body parts in accordance with the law;
n) foreigners are studying in Vietnam was granted a scholarship from the State budget of Vietnam;
o) who serve people with the revolution, include:-The service of Vietnam hero mothers living in families;
-The service of invalids, sick soldiers labor ability decline from 81% or over living in the family;
-The active resistance who served contaminated toxic chemicals deterioration of labor from 81% or over living in the family.
4. The group is State budget support level to close, including: a) the access of poor households;
b) students, students who are enrolled in educational institutions in the national education system;
c) People in households in agriculture, forestry, fishing and match career average living standards there.
5. participate in Group health insurance under household, including: a) the whole of the people named in the Hukou, except the object specified in the paragraph 1, 2, 3 and 4 of this Article and who have declared a temporary absence;
b) the whole of the people named in the book staying, except for the object specified in the paragraph 1, 2, 3 and 4 of this Article;
Example 1: the family B has 5 people with the name in the shared household, including 12 who enjoy pensions, 1 who are public servants; In addition, there are 12 other local people to sign a temporary stay. Number of participants HEALTH INSURANCE under household he B is 4 people.
Article 2. The method of medical insurance premiums for some objects

1. for people who are entitled to pensions, labor lost support, grants monthly social insurance due to the State budget guarantees the provisions in paragraph 2 and point c paragraph 3 article 1 this circular: monthly social insurance organizations, make HEALTH INSURANCE at closing for this object from the source of funds to pay pensions social insurance subsidies, due to State budget guarantees.
2. for people with revolutionary specified in point d, relatives of people with the revolution in i and k Points, who serves people with revolutionizing the provisions in Points o and a social assistance allowance, constant defined in Point g paragraph 3 article 1 of this circular : a) every social insurance organizations, General INSURANCE and card numbers were released and the amount of HEALTH INSURANCE for the closing of this object (model Appendix 1), sending the labor Agency, invalids and Social Affairs the same level to switch the corresponding funding from sources that implement incentive policies for the people of the revolution the source, a policy of social protection to the HEALTH INSURANCE Fund;
b) at the latest until 31 December of every year, the social insurance organisation, in collaboration with the labour and Social Affairs-the same level is done the payment, transfer the funds into the HEALTH INSURANCE Fund of that year.
3. for specified object in points b, d (except people to the Revolution), the points e, h and m paragraph 3 article 1 of this circular and in the near-poor households defined in art. 4 Article 1 this circular which are the State budget 100% support the closed level prescribed in point a and point b of paragraph 1 of article 3 of the Decree No. 105/2014/ND-CP: every social insurance organizations, General INSURANCE and card numbers were released and the amount played, support (model annex 2), sending the financial agencies to transfer funds into the HEALTH INSURANCE Fund as specified in clause 7 of this.
4. for an audience of people in households and poor accessibility provisions in art. 4 (excluding subject 100% supported closing the HEALTH INSURANCE) and in households in agriculture, forestry, fishing and match the average living standards have specified in point c of paragraph 4 Article 1 of this circular : a) periodically 3 months, 6 months or 12 months, representatives of the household directly paid INSURANCE and closing parts of the responsibility to pay for the social insurance organization or agent of HEALTH INSURANCE in the social level;
b) periodically 3 months, 6 months or 12 months, organized social insurance General INSURANCE and card numbers were released, the proceeds of the object and the amount the State budget support (Appendix 2), sending the financial agencies to transfer funds into the HEALTH INSURANCE Fund as specified in clause 7 of this.
5. for students, students who are enrolled in vocational education in national education systems specified in point b of paragraph 4 Article 1 this circular: a) the institution collecting the money to close the section under the responsibility of the student to student, 6 months or a year, filed into the HEALTH INSURANCE Fund;
b) part funds the State budget to support a portion of HEALTH INSURANCE at closing levels as follows: – for students, students who are studying at local institutions would manage the local budget support, irrespective of the student's permanent residence, students: six months the social insurance organisation, General HEALTH INSURANCE card number has been issued, the proceeds of the student, the student and the amount the State budget support (Appendix 2), sending the financial agencies to transfer funds into the HEALTH INSURANCE Fund as specified in clause 7 of this;
-For students, students who are enrolled in educational institutions by the Ministry, the central agency management by the central budget support: six months, organized social insurance General INSURANCE and card numbers were released, the proceeds of the student, the student and the amount the State budget support (Appendix 2) social insurance in Vietnam, sent to General, sent the Finance Ministry to transfer funds into the HEALTH INSURANCE Fund.
c) for students, students of many different subjects specified in paragraph 3 and Article 4, Paragraph 1, point a of this circular are enrolled in educational institutions by the Ministry, the central agencies, the involvement of HEALTH INSURANCE as specified in paragraph 8 of this Article and present the HEALTH INSURANCE card for educational institutions when establishing HEALTH INSURANCE participation list level, avoiding the overlap of HEALTH INSURANCE card.
6. for group participants HEALTH INSURANCE under household prescribed in clause 5 1 of this circular: periodically 3 months, 6 months or 12 months, representatives of the household directly paid for INSURANCE and closing social insurance organizations or agent of HEALTH INSURANCE in the social levels.
7. Financial Regulation based on the hierarchy of local budget management and aggregate table object, the expense of the State budget to close, close support MEDICAL INSURANCE COVERAGE due to social insurance organizations move to, have a responsibility to move funds into the HEALTH INSURANCE Fund every quarter; at the latest until 31 December of every year is done the transfer of funding to the HEALTH INSURANCE Fund of that year.
8. where a person simultaneously in multiple objects involved different HEALTH INSURANCE specified in article 1 of this circular, then close the HEALTH INSURANCE according to the first object which the person identified in the order of the objects specified in article 1 of this circular.
Article 3. Determine the amount of close, close support for some objects when the State adjusted levels of medical insurance premiums, the base salary is 1. For group objects specified in Clause 3 1 of this circular and the object people in households and poor access to the provisions in point a paragraph 4 to article 1 of this circular are the State budget 100% support level to close: close State budget amount, 100% support the closed level is determined by the level of base salary and HEALTH INSURANCE at closing that corresponds to the items on the shelf HEALTH INSURANCE card. When state regulators closed level of HEALTH INSURANCE, the base wage adjustment, the amount of the State budget, the support is adjusted from the date of application of the new HEALTH INSURANCE at closing levels, the new base salary.
2. for target groups are State budget support level to close part of HEALTH INSURANCE specified in Clause 4 1 of this circular: HEALTH INSURANCE participants periodically closed 3 months, 6 months or 12 months, the amount of the participation and support of State budget is determined according to the extent of closing the base salary and HEALTH INSURANCE at the time of closing of HEALTH INSURANCE. When state regulators closed level of HEALTH INSURANCE, the base wage adjustment, the participants and the State budget to supplement the difference due to the adjustment of the level of HEALTH INSURANCE, closing the base salary for the remaining time that participants had HEALTH INSURANCE at closing.
Example 2: Mr. M in the vicinity of the closed HEALTH INSURANCE for poor households by 2015. At the time of January 2015, close is 4.5% level, the base salary is 1,150,000 VND; assuming from 5/2015, the State base wage adjustment over 1,200,000; the amount of he M and the support of the State budget is determined as follows: – the case of Mr. M made close 6 months in January and July, the closing amount, support the first 6 by 4.5% and closing level the base wage 1,150,000 VND/month (he is M and the State budget to supplement the difference by adjusting the basic wage the Department for the duration of two months 5 and 6). The amount played, last 6 months support is calculated according to the level of 4.5% and closed the base salary is 1,200,000 VND/month.
-Where he played once for the whole year M in January, the amount of plays, support is calculated according to the level of HEALTH INSURANCE 4.5 percent and close the base salary is 1,150,000 VND/month (Mr M and the State budget to supplement the difference by adjusting the base wage from May to December, 2015).
3. for group participants HEALTH INSURANCE under household prescribed in clause 5 1 of this circular: HEALTH INSURANCE participants close periodically April 3, 6, or 12 month close close levels are determined by declining from the second onwards members as defined in Point g clause 1 article 2 of Decree No. 105/2014/ND-CP and base salary at the time of closing the HEALTH INSURANCE. When state regulators closed level of HEALTH INSURANCE, the base wage adjustment, the participants do not have to close the disparity in part due to additional adjustments of the level of HEALTH INSURANCE, closing the base salary for the remaining time has closed HEALTH INSURANCE.
Example 3: case 4 family man Mr. B in example 1 in clause 5 article 1 of this circular, closed HEALTH INSURANCE needs for the entire year, the amount of HEALTH INSURANCE are determined close as follows (where State regulators base salary shall apply as for example 2 in paragraph 2 of this Article) :-First Person: 1,150,000 VND x 4.5% x 12 months = 621,000.
-Second person: Dong x 70% = 434,700 621,000.
-The third person: Dong x 60% = 372,600 621,000.
-Wednesday: Dong x 50% = 310,500 621,000.
Chapter II ESTABLISHMENT of the LIST of PARTICIPANTS, the LEVEL of medical INSURANCE CARD article 4. Responsible for establishing the list of participating medical insurance 1. The employers list join the HEALTH INSURANCE of the object specified in clause 1 1 of this circular, sent the social insurance organization.
2. the people's Committee of social INSURANCE and of the participants listed the objects specified in paragraphs 2, 3, 4 and 5 article 1 this circular under household, except the object specified in the point a, l and n Point paragraph 3, point b paragraph 4 Article 1 of this circular social insurance, sending districts, namely: a) in 2015, social people's Committee established the list of local HEALTH INSURANCE participants and submit 1 a list of district level social insurance is the slowest October 1, 2015;
b) From 2016, monthly social people's Committee established the list increased, rising audience participation on HEALTH INSURANCE and submit 1 a list of social insurance at district level to adjust the level of local HEALTH INSURANCE card.
3. educational establishments and vocational training is responsible for establishing a list of participating MEDICAL INSURANCE COVERAGE of the subject by the Ministry of education and training, Ministry of labor, invalids and social affairs management in accordance with Points n and art. 3 and point b paragraph 4 Article 1 of this circular , send the social insurance organization is 31 October at the latest each year.
4. social insurance organizations get involved list of HEALTH INSURANCE as defined in paragraph 2 and Paragraph 3 of this article, have the responsibility to host, in cooperation with the Agency, a management unit of your object before granting HEALTH INSURANCE card.

5. The list of participants of HEALTH INSURANCE for these objects by the Ministry of defence and the Ministry of public security management defined in art. 1 article 1; Point a, point l (except children under 6 years old) and point n paragraph 3 article 1; Point b paragraph 4 Article 1 of this circular to follow the prescribed text.
Example 4: I Q under 6 years old is the son of military officer, subject to the provisions in point e article 1 paragraph 3 of this circular. According to the provisions in article 17 paragraph 1 point b modified, addition of the HEALTH INSURANCE Law then I Q is the people's committees of communes of residence make a list of participating INSURANCE and send social insurance card HEALTH INSURANCE grants to the district level, local budgets to ensure the close source of HEALTH INSURANCE.
6. The list of participants of HEALTH INSURANCE was established in the form of social insurance by Vietnam.
Article 5. Health insurance card 1. HEALTH INSURANCE card form by the Vietnam social insurance issued after the opinion of the Ministry of health. HEALTH INSURANCE card reflects some of the following information: a) the code of HEALTH INSURANCE card HEALTH INSURANCE card: code to unity according to personal identification number by competent State bodies. The case of competent State agencies haven't issued a personal identification number, then the Vietnam social insurance code provisions for participants of HEALTH INSURANCE each participant guaranteed HEALTH INSURANCE have a code only HEALTH INSURANCE card;
enjoy HEALTH INSURANCE rate code b) of participants under the provisions in article 22 amendments, supplements of the law on HEALTH INSURANCE and article 4 of Decree 105/2014/ND-CP;
c) duration of use indicated on cards made according to the provisions in paragraph 3 article 16 amendments and supplements of the law on HEALTH INSURANCE; the time limit for use of the HEALTH INSURANCE card recorded on some objects such as the following:-for those who enjoy unemployment benefits, the duration of use indicated on the respective HEALTH INSURANCE card with the time limit was entitled to unemployment benefits in the unemployment allowance decision of State agency authority;
-For children under 6 years, the duration of use indicated on the HEALTH INSURANCE card as from birth to 72 months old enough young day. The young case, 72 year old enough that the intake is less than the time limit for use of HEALTH INSURANCE card to record on September 30 of that year;
-For the minorities living in regions with socio-economic difficulties; people are living in regions with socio-economic conditions particularly difficult; people are living in the island Township, district of the island: the shelf on the HEALTH INSURANCE card from 1 January until 31 December of that year or on December 31 of last year indicated on the card of HEALTH INSURANCE (HEALTH INSURANCE card shelf level years);
-For people in poor households, who belonged to the household of the near-poor are State budget support 100% close: the shelf on the HEALTH INSURANCE card from 1 January until 31 December of that year. The event, organized social insurance get HEALTH INSURANCE participants list attached to the decision approving the list of persons in poor households, the access of poor households in the State Agency of competent jurisdiction after July 1, the time limit for use of HEALTH INSURANCE card from the date recorded on the decision to this effect;
-For people in the households of the near-poor are the State budget contributes a level close and people in households in agriculture, forestry, fishing and match career average living standards are: the duration of use indicated on the card of HEALTH INSURANCE from participants paid close HEALTH INSURANCE corresponds to the time limit under the policy is entitled to decide on approval of the list of people in the household access poor and people in households in agriculture, forestry, fishery and matchsticks have the standard of living of the average competent State agencies; the case involved the first HEALTH INSURANCE then the expiry stated on the card of HEALTH INSURANCE after 30 days from the date the participants paid close of HEALTH INSURANCE;
-For pupils, students, term of use indicated on the card of HEALTH INSURANCE from January 1 to December 31 of that year; for students in a class and the students of the first year of the term of use indicated on the INSURANCE card from the day of admission or the expiration date of the card of HEALTH INSURANCE are issued before December 31 next year; for students grade 12 students last year and the duration of use indicated on the card of HEALTH INSURANCE from January 1 to the last day of the month concludes that;
-For participants other HEALTH INSURANCE, duration of use indicated on the card of HEALTH INSURANCE by the Vietnam social insurance regulations.
d) From 01/01/2016, HEALTH INSURANCE card issued to participants must show continuous engagement time earlier by month, a maximum of 60 months, except the object specified at points a, d, e, g, h and i in Point paragraph 3 article 1 of this circular. Continuous HEALTH INSURANCE at the time involved is the time used on the HEALTH INSURANCE card the next serial with the expiry date of the card before use; the case of interruption must not exceed 3 months;
Workers were sent to study or work abroad, the time involved the continuous WORLDWIDE COVERAGE including time studying or working in foreign countries until a decision back to the work of the Agency, the Organization sent;
Employees to work in foreign countries, during 60 days from the date of entry of the water if taking HEALTH INSURANCE then time join the continuous WORLDWIDE COVERAGE including the whole time going overseas labor and time since returning to join HEALTH INSURANCE;
Workers who do time in wait mode affect unemployment benefits under the provisions of the law on employment if not join HEALTH INSURANCE according to the other group, the time involved the continuous WORLDWIDE COVERAGE includes procedure affected the waiting time mode to unemployment benefits under the provisions of Employment Law.
Example 5: Mr M had time to join HEALTH INSURANCE on continuously from December 21, 2013 to 31/12/2015; time to join the HEALTH INSURANCE card HEALTH INSURANCE on continuously have the shelf from 01/01/2016 as follows: "the join time constantly until 31/12/2015: October 24 October".
Example 6: Mr. V had time to join continuous WORLDWIDE COVERAGE to 31/12/2015, 70; time to join the HEALTH INSURANCE card HEALTH INSURANCE on continuously have the shelf from 01/01/2016 as follows: "the join time constantly until 31/12/2015: over 60 months".
Example 7: Mrs. K to work at a business and have continuous HEALTH INSURANCE at closing from 01/01/2013, on 05/01/2015 then termination of labor contracts. Mrs K filing unemployment benefits on 04/4/2015 (within 3 months); the competent authority issuing the decision affected unemployment on 20/3/2015 (within 20 days); social insurance organizations get decided on 26/4/2015 and make the payment of unemployment benefits for workers from October 1, 2015 (within 3 months). In this case, the time involved the continuous WORLDWIDE COVERAGE to 30/4/2015 is 28 months.
2. The provision of HEALTH INSURANCE cards for people who have donated organs as defined by law as follows: a) medical facility where the retrieved body parts of responsible people "have donated organs" on paper out of the Institute;
b) social insurance organization paper base hospital specified in point a of this Paragraph-level HEALTH INSURANCE cards to people who have donated organs and to inform the Committee that the township-level people's residences;
c) duration of use indicated on the INSURANCE card from the donated body parts out of the Institute.
Chapter III ORGANIZATION of examinations, CURE health insurance article 6. The base doctor, heal, healing, registration and examination transit, cure health insurance 1. The base doctor, cure HEALTH INSURANCE is health facility under the provisions of law examinations, cure has signed examinations, INSURANCE and healing with social insurance institutions.
2. Registration, INSURANCE and original healing and curative examinations, transit INSURANCE and made according to the regulations of the Minister of health.
Article 7. Contract doctor, cure health insurance 1. General principles: a) the social insurance organization responsible for signing the contract with the medical establishment. Contract examination and treatment of HEALTH INSURANCE are established according to the form prescribed in Appendix 3 attached to this circular. Depending on the conditions of medical establishments, social insurance institutions and health systems base for additional content in the contract but not contrary to the provisions of the law on HEALTH INSURANCE;
b) effect of the duration of the contract according to the fiscal year, from July 1 to December 31 of that year; with respect to the first contract is calculated from the date of signing to the date of December 31 of that year;
c) medical expenses, of healing for participants of HEALTH INSURANCE to the medical examination and treatment before January 1 but released since January 1, then do the following:-case basis contracted continuing medical treatment, cure, the consultation fees charged to the following year, healing;
-Medical case not continue consultation contract, healing, then charged to the cost of medical examination and treatment years ago.
2. contracted medical records, INSURANCE and healing: a) for contracted medical facility for the first time:-dispatch contract proposal of health facilities;
-Permit the operation of health facilities;
-Decide the Division of Hospital Authority (if any); medical establishments, non healing must be decided online technical expertise of the authority.
b) for contracted medical facility per year: additional functions and tasks, the range of expertise, the hospital was granted the approval authority (if any).
3. Procedure of contract for medical examination and treatment of HEALTH INSURANCE: a) for contracted medical facility for the first time:-medical establishment sent 1 record specified in point a of Paragraph 2 of this Article to the social insurance organization according to the hierarchy of social insurance in Vietnam;
-Within a period of 30 days from the date of receipt of a valid application (by date written on the check mark to), the Organization of social insurance are done reviewing the record and signed; the case did not agree to sign the contract, then the cure must have text answers and stating the reason.
b) for contracted medical doctor, cure every year: medical and social insurance organizations completed the signing of HEALTH INSURANCE the following year before 31 December.
4. Contract the examination and treatment of HEALTH INSURANCE at the clinics and the Agency's medical unit, school: a) for communal clinics:-Organization of social insurance contracts with the district hospital or medical center district where no separate district hospital or other medical facility by the Department of health for approval to perform examinations the original, healing at the medical Station for Township HEALTH INSURANCE participants.

-Within the Foundation examination and treatment was delivered, the hospital district or district health center or medical facility approved by the Department of health is responsible for the supply of drugs, chemicals, medical supplies for clinics and pay to use beds (if available) and the technical service by medical clinics communes made in the scope of expertise; at the same time, monitoring and tracking of cases to pay the social insurance organization.
-The total cost of medical examination and treatment at clinics minimum Township by 10% and the maximum cannot exceed 20% of the Fund's consultations, outpatient curative HEALTH INSURANCE card number on the registration, initial healing at the medical Station was determined according to the provisions of point b paragraph 4 Article 11 of this circular.
-Time to save a patient to follow up and treatment at clinics not too township 3 days; for clinics in the area of socio-economic conditions are difficult, extremely difficult, the island Township, district of the island no more than 10 days.
b) with respect to the Agency's health facilities, units, schools (except agencies, units, schools are funding the initial health care as defined in Points b and c of paragraph 1 article 6 of Decree 105/2014/ND-CP): agencies, units, schools, health facilities management contract directly with the social insurance organization and is responsible for the supply of drugs chemicals, medical supplies, medical engineering services to ensure the required medical examination and treatment. The case Agency, units, schools, health facilities management equivalent of communal clinics failed the drug supply, chemicals, medical supplies, medical engineering services to ensure the required medical examination, treatment, social insurance organisations signed a contract through the hospital district or district health centre.
5. for clinic regional hospital district or district health centre: as for the hospital district or district health centre. Regulatory base of expertise, pricing services, healing granted approval authority, social insurance organisations and district hospital or health center for consultation in contract, healing at the clinic area.
Article 8. Consultation procedure, cure health insurance 1. STUDENT HEALTH PLAN participants when treatment, healing must present the HEALTH INSURANCE card with photo; the case of HEALTH INSURANCE card does not yet have a photo then must present a kind of proof about the identity of that person.
2. Children under 6 years old to the doctor, the only cure is to present the HEALTH INSURANCE card. The case does not present a HEALTH INSURANCE card still enjoy rights of participants HEALTH INSURANCE but must present a birth certificate or birth certificate; the case must be treated immediately after birth that does not yet have his birth certificate, the head of the medical establishment and the parent or guardian of the child to sign on to record as a basis of payment as stipulated in paragraph 2 article 13 this circular and is responsible for confirming this.
3. Participants of HEALTH INSURANCE in the time card, HEALTH INSURANCE card change when treatment, healing must present the appointment card, HEALTH INSURANCE card change due to social insurance institutions where the receiving card profile, change the card level and a kind of proof about the identity of that person.
4. People have donated organs to patients, cure shall produce the documents defined in paragraph 1 or Paragraph 2 or Paragraph 3 of this article. The case must be treated immediately after the donation that has not had HEALTH INSURANCE card still enjoy rights of participants of HEALTH INSURANCE; the heads of the medical facility where the retrieved body parts and the patient or relatives of sick people signed on to record as a basis of payment as stipulated in paragraph 3 article 13 this circular and is responsible for confirming this.
5. transit case consultations, healing, HEALTH INSURANCE participants must present the documents defined in paragraph 1 or Paragraph 2 or Paragraph 3 of this article and the transit paper as specified by the Minister of health.
6. in case of emergency, participants of HEALTH INSURANCE is up to the doctor, healing at any medical facility and must present the documents defined in paragraph 1 or Paragraph 2 or Paragraph 3 of this article prior to discharge. At the end of the emergency phase, the patient was medical transfer to departments other treatment at the facility to continue monitoring, treatment or consultation, healing transit as the case of the doctor, cure properly prescribed routes.
Medical establishments no contract doctor, cure HEALTH INSURANCE, when the patient, the medical establishment has the responsibility to give the patient the status confirmations, the valid documents related to medical expenses, healing to the sick pay social insurance organization as defined in article 14 15, and article 16 of this circular.
7. The participants examined HEALTH INSURANCE under a doctor's appointment at a medical facility on the route did not pass the medical establishment registration, initial healing must present the documents defined in paragraph 1 or Paragraph 2 or Paragraph 3 of this article and paper appointment. Each paper appointment back is only valid for use once by the time stated in the appointment. Based on the condition and the required expertise when sick people to visit again, doctors decided the continuation of appointments for patients.
8. Participants HEALTH INSURANCE treatment, cure that is not in the emergency situation during a business trip; mobile work; school focus according to the form of training, training program, staying then be patient, early healing at the medical facility of the same online technical expertise or equivalent with base registration, initial healing items on the HEALTH INSURANCE card must present the documents defined in paragraph 1 or Paragraph 2 or Paragraph 3 of this article and the one of the following papers ( the original or a copy): working paper, decided to study, proof of registration of staying.
9. Health facilities, social insurance institutions are not regulated more administrative procedures in examination and treatment of HEALTH INSURANCE, in addition to the procedure specified in this article. The case of health facilities, social insurance organizations need HEALTH INSURANCE card copy, transfer paper, papers related to examinations, the healing of the sick person to serve for the management then have to manually copy, not asking the patient copy or pay for the expenses.
Article 9. Health insurance inspection 1. Social insurance organizations implement the assessment of HEALTH INSURANCE and are responsible for the results of the assessment in accordance with the law on HEALTH INSURANCE.
2. The content of HEALTH INSURANCE examiner, include: a) check out procedural examinations, cure HEALTH INSURANCE as defined in article 8 of this circular;
b) test, reviews the treatment, use of drugs, chemicals, medical supplies, medical-technical services in the scope of HEALTH INSURANCE participants enjoyed and day hospitalization the fact of human disease;
c) test, the evaluation identified the cost of examinations, cure HEALTH INSURANCE:-the payment for sick people and medical expense statement, healing outpatient, inpatient, ensure properly reflect the expenses and set up in accordance with the prescribed form;
-Check the settlement proposal costs of medical facilities.
d) in collaboration with the medical staff at health facilities to resolve concerns about the procedure of examination and treatment of HEALTH INSURANCE, about the rights, responsibilities of participants HEALTH INSURANCE; direct contact with the patient at the treatment rooms, to answer, common law policy of HEALTH INSURANCE.
3. The assessment of HEALTH INSURANCE at the same time be made or done after the patient discharge and ensure accurate, publicly, transparently. Results of the assessment to be made in writing and notify the medical facility.
4. The content of HEALTH INSURANCE examiners must ensure consistency between medical and social insurance institutions. The case has not yet unified, they must specify the comments of the parties and report on the Agency to resolve.
5. social insurance Vietnam Guide content, process evaluation of HEALTH INSURANCE after the opinion of the Ministry of health.
Chapter IV PAY the DOCTOR, cure health insurance BETWEEN the SOCIAL INSURANCE AGENCY and 10 health facilities. Periodic payment capacity 1. General principles: a) to the payment of interest is paid according to the rates determined in advance by the scope of service for an early registration card at the facility providing medical services in a certain period of time (hereinafter the performance fee);
b) Of certain funds are paid is calculated according to the amount of HEALTH INSURANCE card number registration and performance fees have been determined;
c) medical establishments are actively use funding sources have been identified during the year to provide medical services for the sick person has HEALTH INSURANCE card and do not collect any additional expenses would range in the interests of the patient has HEALTH INSURANCE card. Social insurance organizations are responsible for monitoring and ensuring the rights of sick people have the HEALTH INSURANCE card.
2. Determine the fixed fund performance: a fixed interest Fund) allocated to health facilities annually by capping fees (x) with the total number of HEALTH INSURANCE card, registration, INSURANCE and healing in the initial year and adjusted according to the coefficient of k specified in point d of this Paragraph;
b) Capping the charge is determined by technical expertise, with the total cost of the doctor, cure HEALTH INSURANCE according to the technical expertise online years ago divided (:) for total HEALTH INSURANCE card registration, initial healing of the same technical expertise online years ago; c) total cost of examinations, cure HEALTH INSURANCE according to technical expertise in online years ago is costing consultation , healing of people have HEALTH INSURANCE card by local social insurance, registration, initial healing at the medical establishment line, include: the cost in medical establishments of the same online technical expertise within and outside the province, the costs of medical examination and treatment in different health facilities where the sick person the original registration , except for the expenses specified in point this DD;
d) k coefficient is the coefficient of tuning due to fluctuations in the cost of medical treatment and other related elements of next year compared with the previous year. K coefficient applied in 2015 is 1.10; from 2016 to adjust drug group price index and the medical service of the year before due to the adjacent General Statistics Office announced;
DD) shipping costs, hemodialysis, prostheses of the human body, heart surgery, interventional cardiology, cancer treatment, hemophilia patients and the cost of the same patient's pay does not count in the total the Fund determined capacity;

e certain Funds allocated to performance) medical establishment does not exceed the Medical Foundation, the healing of the facility as defined in point a or point b paragraph 4 Article 11 this circular minus (-) of the genus to performance arising during the year. Special cases, provincial social insurance social insurance report Vietnam consider, adjust the power adjustment charges but does not exceed the average spending by technical expertise on nationwide due to social insurance in Vietnam identified and reported annually.
3. track, adjust the fixed fund performance: When there is a change in the HEALTH INSURANCE card number registered at the health facility, provincial social insurance is responsible for notifying the medical establishments of HEALTH INSURANCE card and the total number of fixed funds are used. The case cost the doctor, healing changes due to changing price structure services, healing, new health services applications, new drugs and other related elements or functional changes, the Mission of the medical establishment, the two parties unify power charge to redefine and adjust the fixed interest Fund accordingly.
4. Use the designated fund performance: a fixed interest Fund) is used to pay the doctor, cure according to the mode for the HEALTH INSURANCE card registration, healing at that facility, including the costs of medical examination and treatment at clinics, medical establishments and direct payments as defined in article 14 15, and article 16 of this circular. Social insurance organizations are responsible for timely notification for medical costs incurred at other medical institutions and the designated fund performance delivered to health facilities.
b) fixed the power Fund case balance, the medical establishment is the accounting balance is left to the revenue of the business units. Of the balance is to leave must not exceed 20% of the designated fund, the rest moved to the Foundation examination, General healing of the province to manage, use. If the fixed interest Fund, including the costs of medical examination and treatment in the township line units are delivered signed, healing at the medical Station of responsible Township to extract the residual part for medical stations online registration card number Township in each medical Station.
c) fixed Fund case capacity shortfall:-due to objective causes such as increased frequency of consultation, treatment, apply new techniques have huge costs, the social insurance organizations review and 60% minimum payment costs exceeded the funds;
-Due to unforeseen causes such as disease outbreaks, severe disease incidence, the big costs are too high compared to the originally scheduled, the provincial social insurance consistent with Department of health review, additional payment for the medical facility. Medical Foundation case, the healing of the not enough to replenish the social security report Vietnam consider, resolve.
5. medical facility is responsible for tracking the aggregate cost, examination and treatment of the cases have no HEALTH INSURANCE card registration, initial cure at the facility; the cost to capacity specified in point c of Paragraph 2 of this Article to pay the social insurance organization.
Article 11. Payment according to the price of services 1. Payment according to the price of the service is method of payment based on the cost of drugs, chemicals, supplies, medical equipment, medical technical service is used for patients in health facilities.
2. payment according to the price of the services are applicable in the following cases: a) medical establishment has not applied the method of payment as performance;
b HEALTH INSURANCE card may not) registration, initial healing at the medical facility;
c) some disease, group of diseases, medical technical services not included in the fixed Fund of medical application of the method of payment as performance specified in point c of Paragraph 2 article 10 of this circular.
3. Basis of payment: cost of medical technical services is calculated according to the price of services, healing is the competent authority for approval; the cost of drugs, chemicals, medical supplies are calculated according to the purchase price but did not exceed the bid price; the cost of blood, blood products by price payment provisions of the Ministry of health.
4. consultation, healing HEALTH INSURANCE Fund are used in the medical establishment registration, cure HEALTH INSURANCE was originally identified in accordance with paragraph 1 article 17 of this circular, the range of use is as follows: a) for medical facilities performing examinations, outpatient and inpatient healing :-90% to examinations, cure at the facility; genus examinations, cure for the sick to medical examination and treatment in medical establishments and shipping costs (if any);
-the remaining 10% to regulate supplements as defined in paragraph 5 of this Article.
b) medical establishments only make examinations, outpatient cure:-45% for medical examination and treatment at the outpatient facilities; genus examinations, cure for sick people to hospital outpatient treatment at the medical facility and shipping costs (if any);
-5% to adjust, Supplement to medical facility as defined in paragraph 5 of this Article;
-50% of the remainder, the Organization of social insurance is used to pay the cost of medical examination and treatment.
c) social insurance organizations are responsible for the payment of the cost of hospital treatment of the person has HEALTH INSURANCE card at the medical facility and the funding sources used by medical facilities on the HEALTH INSURANCE card.
5. where the costs of examination and treatment beyond the general consultation, healing Fund used the social insurance organizations adjust as follows: a) adjust, additional consultation funds 10%, the rest cure for the base make examinations, outpatient and inpatient healing;
b) adjust, Supplement from 5% of patients, healing Fund remains the only basis for performing examinations, outpatient healing;
c) where after the tune that is still missing, the provincial social insurance has a responsibility to consider the additional payment within the consultation, healing Fund locally; If local funds are not sufficient to regulate the social insurance report Vietnam consider, resolve.
6. The total level of payments for cases of treatment, cure (except registration, initial cure) does not exceed the average actual costs according to the scope of benefits of an inpatient and a weekly medical examination and treatment by a specialist of OPD cases are moved to the previous year (x) with the number of weekly examinations in that year, healing and human (x) with k. annually, the group price index base medicine and medical service of the year before due to the adjacent General Statistics Office announced the social insurance organisation, announcements, adjust the total payments for the medical facility.
The case of costs incurred by changing the pricing structure, healing services, the application of new medical services, new drugs and other related elements or functional changes, the Mission of the medical facility at the discretion of the authority, the costs incurred are organized social insurance payment and calculated in the total costs used during the year as the basis determining the average cost level the following year.
Case of medical use exceeded the total funding levels are not payment of HEALTH INSURANCE funds pay part cost increase.
Article 12. According to the payment conditions 1. Payment by patients or groups of patients as payment packages according to the cost of hospital treatment to be determined for each case according to the diagnosis.
2. classification basis, determine diagnosis for each case of disease or group of diseases made under the provisions of the Ministry of health.
3. The cost of the whole package of each case of disease or group of diseases based on the regulation on the price of medical services, the current cure.
4. Ministry of health guide pilot implementation of payment by patients or groups of patients.
Article 13. Medical insurance billing in some cases 1. The payment of the cost of shipping the sick from the District lines up on the line for the object specified in the d, e, g, h and i in Point paragraph 3 article 1 of this circular in case of emergency or when inpatient treatment is medical transit treatment as follows: a) the case of the patient using the transport of medical INSURANCE Fund, then base payment free shipping, all PM goes on and on for health facilities equal to 0.2 litre level that petrol/km calculation according to the actual distance between two medical facilities and the price of gasoline at the time of use. If there is more than one sick person was transported on a vehicle, the payment level also counted only as for the transport of a sick person. Medical facility receiving sick people sign on the votes of the medical establishment car thing turning sick people away; cases outside office hours, they must have the signature of the physician receiving the patient;
b) where sick people not to use means of transport of the medical establishment, the HEALTH INSURANCE Fund to pay the cost of shipping one way (way) for the patient according to the level by 0.2 liter gasoline/calculated according to the actual distance between two medical facilities and gas prices at the time of transferring the patient up on the route. Health facilities indicated transit is responsible for payment of this account directly to the patient, then pay with HEALTH INSURANCE funds.
2. The payment of the cost of medical examination and treatment for children under 6 years old to the doctor, cure does not present HEALTH INSURANCE: a) medical establishment is responsible for general list of children under 6 years of age have been examined, healing attached snapshot of the birth certificate or birth certificate; the case must be treated immediately after birth that does not yet have his birth certificate, the head of the medical establishment and the parent or guardian of the child to sign on to record as a basis of payment as stipulated in paragraph 2 article 8 of this circular.
b) social insurance institutions to base the list of kids were examined, healing by the medical establishment, responsibility shifted to check, verify the grant of a children's HEALTH INSURANCE card. The case has not yet been issued the card, the card instructions, then subtract the costs of examination and treatment on funding sources used by medical HEALTH INSURANCE card of the child records. The case determined the child was then deducted from card funds used by the medical facility where the child that registration, initial healing.
3. The payment of the cost of medical examination and treatment for people who have donated organs to treat after the donation that has not had HEALTH INSURANCE cards:

a) medical facility where the retrieved body parts who are responsible for General lists of people who have donated and consultation costs, detailed healing follow each month, send social insurance organizations have contracted with medical facilities in paying medical costs healing, HEALTH INSURANCE;
b) social insurance institutions to base the list of people who have donated organs have been examined, healing by the medical establishment moved to have the responsibility of making HEALTH INSURANCE card procedures prescribed and deducted from the funds be used by the medical establishment person's HEALTH INSURANCE card on record.
4. The payment of the cost of medical examination and treatment for the medical technical service by officers of the medical facility on the route follow the program direction, the project assistance, specialized capacity for the line under prescribed by the Minister of health: a) the case of the medical technical services have been approved by the authorized price of HEALTH INSURANCE Fund shall payment according to the approved rates;
b) case medical technical services has not yet been approved, the payment of HEALTH INSURANCE fund prices according to the price of services of technical transfer facility has been approved by the authority. Medical facility receiving the transfer techniques have the responsibility to inform the provincial social insurance technical services is made under the program, the project, at the same time the authority approving the list of technical and medical service prices to do the foundations make when receiving this medical technical and billing.
5. in case of overload, the medical establishment have held consultations, healing HEALTH INSURANCE on holidays, holidays should notify the social insurance institutions to supplement to the consultation contract, before implementation. People who have HEALTH INSURANCE card to visit the sick, the HEALTH INSURANCE Fund payments to be healing in the range of interests and the level of enjoyment of HEALTH INSURANCE. The medical facility is responsible for ensuring the manpower, expertise, conditions must publicly the costs that patients must pay out of range of the participants were entitled to HEALTH INSURANCE and must inform the patient; the patient must pay part of the cost of outside interests and the level of enjoyment of HEALTH INSURANCE (if any).
Chapter V PAYMENT of MEDICAL EXPENSES DIRECTLY, healing BETWEEN SOCIAL INSURANCE and health insurance PARTICIPANTS article 14. Direct payments consultation fees, cure cases of direct payment of the cost of hospital treatment as prescribed in clause 2 article 31 amendments, supplements of the law on HEALTH INSURANCE include: 1. Examination and treatment in medical establishments no contract examination and treatment of HEALTH INSURANCE.
2. The doctor, healing is not the right procedure for medical examination and treatment of HEALTH INSURANCE as defined in article 8 of this circular.
Article 15. Records suggest the payment of 1. The paper suggested the payment of medical INSURANCE under cure model due to social insurance for Vietnam.
2. The procedures, paperwork, as stipulated in article 8 of this circular.
3. The paper out.
4. The original of the valid documents (invoice, purchase invoice currency and payment vouchers are concerned).
Article 16. Direct payments 1. The patient or the patient's relatives are responsible for applying the provisions of article 15 of this circular for social insurance is granted the District of residence.
2. social insurance organizations at district level accountable: a) receiving records suggest the payment of sick people or relatives of the sick person and receipt records. The profile is not sufficient as a rule, the additional requirements for enough;
b) within a period of 30 days from the date of the application payment proposal should complete the assessment and payment of HEALTH INSURANCE costs, direct healing for the sick. Case of non-payment have to answer in writing and stating the reason;
c) synthesize the amount have to pay the doctor, healing for the sick and deducted from the funds be used by the medical facility where people have HEALTH INSURANCE card registration, initial healing.
3. billing Rates: a) patient treatment cases, healing at the medical facility has consultation contract, healing: payment of HEALTH INSURANCE within the scope of the rights and the level of enjoyment of HEALTH INSURANCE under the provisions;
b) case of the patient to the doctor, healing at the medical facility no contract doctor, cure HEALTH INSURANCE: payment according to the actual cost in the range of interests and enjoy HEALTH INSURANCE but must not exceed the levels specified in Appendix 4 attached to this circular.
Chapter VI ADMINISTRATION and USE of the health insurance FUND article 17. Use the Foundation examinations, cure health insurance as prescribed in clause 1 article 6 of Decree 105/2014/ND-CP 1. Fund allocation examinations, cure of HEALTH INSURANCE for the medical establishment registration, initial HEALTH cure: the base of medical healing, HEALTH INSURANCE Fund on the provincial level is determined according to the provisions in clause 1 article 6 of Decree 105/2014/ND-CP, provincial social insurance is responsible for the allocation of funds for the medical establishment registration originally, the cure, the formula is as follows: consultation, healing HEALTH INSURANCE Fund allocation for the medical establishment registration, initial healing = the total examination and treatment of HEALTH INSURANCE Fund on the province-total cost of extracting the original health care spending on the province of x total HEALTH INSURANCE card registration the original, healing at the medical facility HEALTH INSURANCE cards in total of which:-general consultation, healing HEALTH INSURANCE Fund on the area is determined according to the provisions in clause 1 article 6 of Decree 105/2014/ND-CP (by 90% of the money played on HEALTH INSURANCE at the provincial level for examination and treatment).
-Total cost of extracting the original health care spending on the province level is determined according to the provisions in paragraph 2 of this Article.
2. Move the funding for the vocational education in national education systems and the organs, organizations, enterprises are qualified health care according to the provisions of article 18 of this circular: a) for preschool institutions: – the amount quoted to leave for preschool education institutions including two account : by 5% of the total HEALTH INSURANCE funds calculated on the total number of children under 6 years old are enrolled in junior and 1% of the total amount of INSURANCE and monthly closing of the closed facility for social insurance organizations as defined in point c of this paragraph.
In the first months of the school year or course, social insurance organization is responsible for transferring the amount mentioned above for the preschool institution.
Example 8: preschool education institutions B eligible initial health care for children, the 2015 100 children below 6 years of age. Suppose the price level is 4.5% of HEALTH INSURANCE, closing the wage 1,150,000 VND, the base is the amount of social insurance organizations extract transfer for the school is the same: 3,105,000 5% x (100 x 4.5% x young 1,150,000 VND/month x 12 months) in addition, the social insurance organizations have to extract to leave for preschool education institutions B by 1% of the total amount of INSURANCE and closing basis for social insurance organizations According to the society for example 10 at the point c of this Paragraph.
b) other educational establishments:-the amount of extract of leave for educational facilities include 2 account: by 7% of the HEALTH INSURANCE Fund income calculated on the total number of students, students who are enrolled in a participating institution of HEALTH INSURANCE (including students, students taking HEALTH INSURANCE according to group other objects) and 1% of the total amount of INSURANCE and monthly closing of the closed facility for social insurance organizations the Assembly according to the provisions in point c of this paragraph.
-In the early months of the school year or course, social insurance organization is responsible for transferring the amount mentioned above for the institution.
Example 9: K University are eligible for health care students; the year 2015-2016, has 5,000 students, including 100 children in poor households, 100 children are relatives of the military forces, 100 children are relatives of people with revolutionary and 4,700 children in other objects. Assuming the closing levels of HEALTH INSURANCE of objects uniformly is 4.5%, the average base wage 1,150,000 VND; the amount of social insurance organizations to extract copper 217,350,000 is transferred to the 7% x (5,000 students x 4.5% x 1,150,000 VND/month x 12 months) in addition, the social insurance organizations have to extract to leave for College K equal to 1% of the total amount of HEALTH INSURANCE for School closing social insurance organizations as for example 10 at the point c of this paragraph.
c) for funding the initial health care for objects by the Agency, organization, corporate management:-the level of extract of leave for the organs, organizations, enterprises have held health agency by 1% of the total amount of HEALTH INSURANCE at closing (not including INSURANCE and closing delay interest) of the Agency organizations, businesses close for the social insurance organization.
-Monthly, after receiving the money to close the Agency's WORLDWIDE COVERAGE, organizations, enterprises, the social insurance organization responsible for CITES to back the amount mentioned above for the organs, organizations, enterprises.
Example 10: A Business Agency Health Organization (no contract doctor, cure HEALTH INSURANCE) make payment close to the HEALTH INSURANCE Fund, a total of 105 million, of which: 100 million is the amount to be paid according to the level of closed rules, 5 million penalty interest is slowly closing. The social insurance organisation after receiving this money responsibly documented cite to back to business A certain amount is 1,000,000 VND (1% x 100,000,000).
Article 18. Conditions, the scale of the Organization; genus content; management and payment of funds to the original health care at the institution, agency, organization, enterprises 1. Institutions, agencies, organizations, businesses (excluding educational institutions, agencies, organizations, businesses have organized medical consultation contract Agency, healing HEALTH INSURANCE) was granted funding from the Foundation examinations, cure HEALTH INSURANCE health care for objects by institution , agency, organization, management business when there are enough of the following conditions: a) has at least one dedicated person or part-time or term employment contract from enough 3, or more, the minimum level is intermediate, y;
b) Have medical or private office to perform first aid, initially handling for objects by institution, agency, organization, management of business when the accident injury, common disease during the study, working in the institution, the Agency , organization, business.
2. Content of primary health care expenditure:

a) Spent to buy drugs, medical supplies and first aid service, handled initially for children, pupils, students, subjects by the Agency, organization, management of business when the accident injuries and other common illnesses in school time, work in the institution, agency or organization , Enterprise;
b) genus of stores, repair of medical equipment usually serve at the primary health-care institutions, agencies, organizations and enterprises;
c) spent on buying Office products, Cabinet documents the management of health records of children, pupils, students, laborers;
d) Spend to buy books, documents, instruments to serve propaganda, educational curricular, teaching about care, advice health, reproductive health and family planning in educational institutions, agencies, organizations and enterprises;
DD) other expenses to perform primary health care at the institution, agency, organization, business.
3. Management and payment of funds: a) an institution, agency, organization, enterprises are granted funding from the Foundation examinations, cure HEALTH INSURANCE is responsible for the use of health care for the objects by institution, agency, organization, business management , not be used on other purposes.
b) health care expenditures initially prescribed in clause 2 of this is accounting, settlement as follows: – for public institutions perform accounting expenses health initially on cost of medical work done at the base and with superior management units according to the current regulations;
-For external public institutions perform accounting expenses initial health care at the expense of the institution beyond the establishment and settlement with the superior unit (if available);
-For enterprises, economic organizations made opening the private accounting to reflect the reception of funds, use of funds, not the total cost of the settlement into the business;
-For other units, agencies make expenditures accounting health initially on cost to perform the Agency's medical unit, and the settlement with the Agency, superior management unit (if available) or the financial agency according to the current rules.
c) educational establishments, agencies, organizations, businesses are funding the initial health care under the provisions of this settlement not with social insurance institutions but are responsible for reporting on the use of funds when the social insurance organization, the competent State agency requirements.
d) Of funding granted to the end of the year has not yet used up, be transferred to the following year's source to continue use.
Article 19. Support for the social people's Committee to make up the list to join local medical insurance 1. Funding support for social people's Committee to make up the list of local HEALTH INSURANCE participants were deployed from the source estimating apparatus management annual spending of social insurance in Vietnam.
2. The number of support funding is based on the number of people on the list to join HEALTH INSURANCE due to the people's Committee established the township level (for the list of rising, falling objects are calculated according to the number of people falling and number) and by social insurance spending Vietnam reported annually on the basis of the level of financing was approved by the Prime Minister; private spending in 2015 is 1,500 VND/person.
3. transfer of funds spent on support for social people's Committee to make up the list to join local MEDICAL INSURANCE COVERAGE: a) for 2015: the slowest to late March, the district level social insurance is responsible for granting temporary rates by 50% of the funding of support costs charged by the provisions in paragraph 2 of this Article and the total population of the commune people's Committee at the time the the point of support. The rest was enough after getting the list participate in HEALTH INSURANCE as defined in art. 4 Article 4 this circular.
b) From 2016, social insurance districts made funding support for social people's Committee after receiving the list increased, reducing the audience to join HEALTH INSURANCE as defined in point b of paragraph 4 Article 4 this circular.
Example 11:-2015: a population of 6,000 people, the N Township, the amount of grade-level social insurance advance is 4,500,000 Township Council (50% x 1,500 x copper 6,000 people). The remaining amount was enough after getting the list participate in HEALTH INSURANCE as defined in art. 4 Article 4 this circular.
-2016: N increase the report, falling objects, which increased 30 people, off 10. Assuming the costs of HEALTH INSURANCE participants listed apply 2016 is 2,000 VND/person; the amount of support for the town's 80,000 Dong (30 people increase + 10 people falling) x 2,000 Council c) switching support funding are made according to the method of payment bank transfer or directly in cash.
4. The people's Committee of the level of funding granted Township list join the HEALTH INSURANCE budget settlement not a commune but must open a separate ledger to reflect the reception of funds, use of funding.
Chapter VII ENFORCEMENT PROVISIONS article 20. Transitional provisions 1. In 2015, social security organizations do HEALTH INSURANCE card for the target groups on the basis of the list of participants HEALTH INSURANCE Agency, organization, the unit moved to object management. When receiving the list of participating MEDICAL INSURANCE COVERAGE in 2015 of the people's Committee of social, social insurance institutions have the responsibility to scrutinize, guarantee the provision of the card according to the right audience.
2. With regard to HEALTH INSURANCE participants were traffic accidents: a) The case of the treatment before 1/1/2015 but discharge since 01/01/2015 and the traffic accident cases in hospital treatment since 01/01/2015 are HEALTH INSURANCE funds pay the doctor healing within the level enjoyed by the prescribed regimes;
b) case of traffic accidents are caused by violations of the legislation on the traffic of the person causing the HEALTH INSURANCE Fund, was to pay the doctor, cure according to the prescribed regimes and discharge before 01/01/2015 shall not reimburse expenses for HEALTH INSURANCE Fund.
3. in case the patient was appointed medical use technical services defined in the decision No. 36/2005/QD-BYT on 31/10/2005 of the Minister of health on issuing high-tech services listing, major MEDICAL INSURANCE Fund, expenses paid in the range of the level of enjoyment, but not exceed 40, base salary for a technical service to use it for until the Ministry of Health issued a category, rate and payment conditions for medical technical services in the range of entitled participants HEALTH INSURANCE (unless otherwise specified in point b of paragraph 1 article 4 of Decree 105/2014/ND-CP).
4. With regard to the consultation contract, cure HEALTH INSURANCE have signed before the date of this circular effect enforcement, social insurance institutions and health facilities agreed additional amendments for compliance specified in this circular.
Article 21. Effect 1. This circular has effect from January 2, 2015; the provisions of this circular was made from October 1, 2015.
2. The text and the following rules out effective from the date of this circular effect: a) Circular No. 03/2009/TTLT-BYT-BTC on 14/8/2009 of the Ministry of health, Ministry of Finance shall guide the implementation of medical insurance and circular No. 24/2014/TTLT-BYT-BTC dated 14/7/2014 of the Health Ministry-the Finance Ministry revised supplement some articles of circular No. 03/2009/TTLT-BYT-BTC on 14/8/2009 of the Ministry of health, Ministry of Finance shall guide the implementation of health insurance;
b) Circular No. 39/2011/TTLT-BYT-BTC on 11/11/2011 the Ministry of health, Ministry of finance instructed the payment procedure consultation fees, cure for health insurance participants were traffic accidents;
c) following provisions in clause 2 section II circular No. 14/2007/TT-BTC dated 8/3/2007 of the Ministry of finance manual to oversee the funding of health in schools: "with respect to the funds that are left from the Foundation examination and the voluntary medical insurance of the subject the student students: The institution responsible for the management, use and settlement with the social insurance agency under the current rules. "
Article 22. Implementation 1. Social insurance in Vietnam is responsible for: a HEALTH INSURANCE card form), the form-level appointment, change of HEALTH INSURANCE card and process the new level, level back, recovery, HEALTH INSURANCE card, change of custody after the opinion of the Ministry of health;
b) issued a declaration form of first HEALTH INSURANCE participants and guide the participants to set up HEALTH INSURANCE HEALTH INSURANCE card when declarations;
c) group price index base medicine and medical service of the year before due to the adjacent General Statistics Office announced, timely message for social insurance of the province or city to make adjustments costs related to medical examination and treatment of HEALTH INSURANCE for the medical facility;
d) directs the social insurance of the province, in collaboration with the City Department of health, Department of finance, the base doctor, cure HEALTH INSURANCE on the area, neighboring localities and relevant agencies to resolve under the authority or the authorized recommendations timely processing bottlenecks arise;
DD) directing the grant of social insurance provides forms, information software (if any) for the people's Committee in the township level list, manage a list of participating local HEALTH INSURANCE under household;
e) Guide to the social insurance of the province, the city of the base certificate from the currency part of the same costs paid by patients to identify the same amount paid in the year is estimated to certification are not the same pay in years for people who have time to join HEALTH INSURANCE 5 consecutive years or over and have the same amount of money to pay medical expenses healing, in greater than 6 months base salary, unless a doctor himself, healing is not the right route specified in point c of paragraph 1 Article 22 amendments, supplements of the law on HEALTH INSURANCE.
Example 12: Come on 01/5/2015, Mr. A has continuous HEALTH INSURANCE at the time involved 60 months and the same amount to pay consultation fees, cure accumulatively from 01/01/2015/01 to 5/2015 is 7 million (greater than 6 months base salary). From 1/5/2015 to 31/12/2015, A 100% payment of HEALTH INSURANCE fund the cost of medical examination and treatment within the HEALTH INSURANCE benefits.
2. The Department of health is responsible for:

a) presiding, in collaboration with the provincial social insurance, the popular medical director holding examinations, cure for participants in local HEALTH INSURANCE as prescribed in the law on HEALTH INSURANCE, the law on amending and supplementing a number of articles of the law on HEALTH INSURANCE, Decree No. 105/2014/ND-CP and this circular;
b) presiding, in cooperation with the Department of health and social insurance related provincial in neighboring localities to organize consultations, healing and transit technical expertise to facilitate the involvement of HEALTH INSURANCE.
3. The base doctor, cure HEALTH INSURANCE has a responsibility: a) promote the application of information technology in the medical management and treatment. The medical establishment already have or are building management software then collaborated with the social insurance organization to unify the statistical indicators at the request of management consultation; These facilities are not yet available, the research management software, application software by social insurance Vietnam deployment applied, proceed to unify a general management program;
b) presiding, in collaboration with the social insurance organisation, applying the construction program management, cost control, cure.
In the process if there are obstacles, the proposal reflects the timeliness of the Ministry of health and the Ministry of finance to study the resolution./.