Terminology and principles of health insurance according to legal regulations

According to Article 2 of the Health Insurance Law 2014, health insurance terms are understood as follows:

1. Health insurance is a form of compulsory insurance applied to subjects prescribed by this Law for health care, not for profit purposes organized by the State.

2. Universal health insurance means that all subjects specified in this Law participate in health insurance.

3. Health insurance fund is a financial fund formed from health insurance premiums and other legal revenue sources, used to pay medical examination and treatment costs for health insurance participants, and management costs. of health insurance organizations and other legal expenses related to health insurance.

4. Employer including state agencies, public service units, people's armed units, political organizations, socio-political organizations, socio-political-professional organizations, social organizations, socio-professional organizations, enterprises, cooperatives, individual business households and other organizations; Foreign organizations and international organizations operating in Vietnamese territory are responsible for paying health insurance.

5. Medical examination and treatment facilities covered by health insurance Initially, it was the first medical examination and treatment facility registered by health insurance participants and recorded in the health insurance card.

6. Health insurance appraisal is a professional activity conducted by a health insurance organization to evaluate the reasonableness of providing medical services to health insurance participants, as a basis for paying medical examination and treatment costs. health insurance.

7.3 Households participate in health insurance (hereinafter referred to as household) includes all people named in the household registration book or temporary residence book.

8.4 Basic medical service package paid by health insurance fund are essential medical services for health care, consistent with the affordability of the health insurance fund.

According to Article 3 of the Law on Health Insurance 2014 regulations on nHealth insurance principles are as follows:

1. Ensure risk sharing among health insurance participants.

2.5 The health insurance premium is determined according to the percentage of salary as the basis for compulsory social insurance payment according to the provisions of the Social Insurance Law (hereinafter referred to as monthly salary), pension , stipend or base salary.

3.6 The level of health insurance benefits depends on the level of illness, the group of subjects within the scope of benefits and the period of participation in health insurance.

4. Medical examination and treatment costs covered by health insurance are paid jointly by the health insurance fund and health insurance participants.

5. The health insurance fund is managed centrally, uniformly, publicly, transparently, ensuring balance of revenue and expenditure and protected by the State.