Information about health insurance for children under 6 years old is of special interest, because right from the moment they are born, they have been entitled to free health insurance until they are 6 years old. These are the contents that parents need to know.
Accordingly, based on Clause 7, Article 3, Decree 146/2018/ND-CP and Clause 6, Article 1 of the Law on Health Insurance amended in 2014, children under 6 years old are eligible for health insurance and are granted free health insurance cards (groups paid by the state budget), parents do not have to pay health insurance premiums for their children until they are 6 years old.
Procedures for issuing health insurance cards for children under 6 years old
In order for children to enjoy health insurance benefits for children under 6 years old, parents need to make a dossier for a health insurance card for children. After being granted a health insurance card, children are given free medical examination and treatment at public hospitals according to regulations.
Dossiers for granting health insurance cards for children include: Copy of birth certificate or copy of birth certificate with notarized stamp; List or request for health insurance card of the People's Committees of the communes, wards and towns where the child resides.
One thing to note is that based on Clause 2, Article 15, Decree 146/2018/ND-CP, in the case of a newborn child, who does not have a copy of the birth certificate or a copy of the birth certificate, the head of the medical examination and treatment facility and the child's father or mother or guardian sign the medical record to be the basis for payment as prescribed in Clause 1, Article 27, Decree 146/2018/ND-CP and is responsible for this confirmation.
After completing the application for health insurance registration for children, parents will submit it to the original agencies at the commune, district or equivalent medical examination and treatment establishments; unless registered at the provincial medical examination and treatment facility or the central hospital according to the regulations of the Minister of Health to be granted a health insurance card.
After 10 working days from the date of receipt of the prescribed documents, health insurance organizations must issue health insurance cards for children.
Children under 6 years old are subject to full support by the State for the health insurance premium, that is, parents do not need to pay for this insurance.
When examining and treating children at medical facilities covered by insurance, children receive the following benefits:
In case of the right line: Enjoy 100% of medical examination and treatment costs, no payment rate limit applies for drugs, medical supplies, chemicals, and technical services.
In case of left line: Enjoy 40% of inpatient treatment costs at the central hospital, 100% of inpatient treatment costs at provincial hospitals and 100% of inpatient treatment costs at district hospitals. If the child is examined and treated in outpatients at the provincial and central levels, the health insurance will not cover it.
In case of emergency: Children under 6 years old are examined and treated at any medical facility, enjoy 100% of the cost and do not have a limit on the payment rate for drugs, medical supplies, chemicals, technical services.
To participate in health insurance, parents need to prepare a birth registration declaration, a child's birth certificate issued by the hospital and a declaration of participation in health insurance. When completing the paperwork, parents submit them to the commune-level People's Committee and wait for notice.