If I forget my health insurance card when going to the doctor, will I still be paid?

Direct payment of health insurance examination and treatment fees

Regarding the rights of health insurance participants such as Ms. L's case, the representative of the Social Insurance agency said that according to the provisions of Clause 4, Article 30 of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government , people with health insurance cards who go to the place of initial health insurance examination and treatment but do not present their health insurance cards will be directly paid by the Social Insurance agency for health insurance examination and treatment costs.

Social insurance will pay according to actual costs within the scope of benefits and health insurance benefits, but not more than 0.15 times the basic salary at the time of medical examination and treatment for outpatient medical examination and treatment and not more than 0.5 times the basic salary at the time of hospital discharge for inpatient medical examination and treatment.

Integrating health insurance card into ID card or VssID application helps people to have more convenience when examining and treating diseases.

To make payment, health insurance participants need to bring their documents to the district-level social insurance agency where they reside for settlement. The documents include: Photocopies of the following documents (bring the original for comparison): health insurance card, photo identification; medical examination form or medical examination book of the medical examination for which payment is requested; original invoice and related documents.

In principle, the Health Insurance Fund covers the costs of health insurance examination and treatment (medicines, medical supplies, technical services) according to the list and price levels prescribed by the Ministry of Health . Therefore, health insurance participants will be paid by the Social Insurance agency for costs within the scope of payment of the Health Insurance Fund and the level of benefits on the Health Insurance card.

For the difference in costs due to medical examination and treatment at the required medical examination and treatment area (if any), the health insurance participant must pay by himself/herself.

Health insurance card can be integrated into citizen identification card

Implementing Decision 1911 of the Prime Minister, the Ministry of Public Security has coordinated with Vietnam Social Security to synchronously deploy data from the national database on insurance and the national database on population, integrating information on health insurance cards into citizen identification cards, serving people and health agencies to authenticate citizen information when going to medical examination and treatment at medical facilities.

Some notes when integrating health insurance information into ID card: Health insurance card must be valid; ID card must have QR code; Information on ID card and health insurance card must be accurate.

How to integrate health insurance card and citizen ID card :

- People only need to bring their ID card and valid health insurance card to the nearest social insurance agency to request integration. After integration is completed, they will receive an ID card with integrated health insurance information.

- People can integrate health insurance information into their chip-based ID cards online on the Vietnam Social Security Public Service Portal website using the function of changing the citizen ID number on VssID.

This method is applied in cases where people have registered to use the VssID application before having a 12-digit chip-embedded ID card.

After people successfully update their chip-embedded ID card information to the system, their health insurance card data will be automatically integrated into their chip-embedded ID card. At this point, people can go to the doctor using their chip-embedded ID card.

- Employees can use the VssID application to integrate their health insurance card into their chip-embedded ID card in case they already have a 12-digit chip-embedded ID card and have not registered to use VssID.

When registering for a VssID account using a chip-based ID card, the individual's health insurance card will be automatically integrated into that individual's ID.

Source: https://www.baogiaothong.vn/di-kham-quen-the-bhyt-nguoi-benh-co-duoc-thanh-toan-192231221092545692.htm