Thông tư liên tịch 09/2009/TTLT-BYT-BTC của Bộ Y tế và Bộ Tài chính hướng dẫn thực hiện bảo hiểm y tế

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Thông tư liên tịch 09/2009/TTLT-BYT-BTC của Bộ Y tế và Bộ Tài chính hướng dẫn thực hiện bảo hiểm y tế
Cơ quan ban hành: Bộ Tài chính; Bộ Y tế Số công báo: Đã biết
Số hiệu: 09/2009/TTLT-BYT-BTC Ngày đăng công báo: Đã biết
Loại văn bản: Thông tư liên tịch Người ký: Phạm Sĩ Danh; Nguyễn Thị Xuyên
Ngày ban hành: 14/08/2009 Ngày hết hiệu lực: Đã biết
Áp dụng: Đã biết Tình trạng hiệu lực: Đã biết
Lĩnh vực: Y tế-Sức khỏe , Bảo hiểm
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THE MINISTRY OF HEALTH
THE MINISTRY OF FINANCE
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No. 09/2009/TTLT-BYT-BTC
SOCIALIST REPUBLIC OF VIETNAM
Independence- Freedom- Happiness
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Hanoi, August 14, 2009

JOINT CIRCULAR
Providing guidance on health insurance
 
Pursuant to the November 14, 2008 Law on Health Insurance;
Pursuant to the Government’s Decree No. 62/2009/ND-CP dated July 27, 2009, detailing and guiding a number of articles of the Law on Health Insurance;
Pursuant to the Government’s Decree No. 60/2003/ND-CP dated June 6, 2003, detailing and guiding the implementation of the Law on the State Budget;
The Ministry of Health and the Ministry of Finance jointly guide a number of articles of the Law on Health Insurance and the Government’s Decree No. 62/2009/ND-CP dated July 27, 2009, detailing and guiding a number of articles of the Law on Health Insurance (below referred to as Decree No. 62/2009/ND-CP), as follows:
Chapter I
PAYERS, RATES OF, AND RESPONSIBILITY TO PAY, HEALTH INSURANCE PREMIUMS
Article 1.
Health insurance participants defined in Article 12 of the Law on Health Insurance and Article 1 of Decree No. 62/2009/ND-CP
1. Laborers, business managers, cadres, civil servants and employees defined in Clause 1, Article 12 of the Law on Health Insurance include:
a/ Laborers, including foreigners, working in the following agencies, units, organizations and enterprises:
- Enterprises established and operating under the Enterprise Law and the Investment Law;
- Cooperatives and cooperative unions established and operating under the Law on Cooperatives;
- State agencies, non-business units, armed forces units, political organizations, socio-political organizations, socio-political-professional organizations, socio-profession organizations and other social organizations;
- Foreign agencies and organizations or international organizations based in Vietnam, unless otherwise provided for in a treaty to which the Socialist Republic of Vietnam is a contracting party;
- Other laborer-employing organizations established and operating under law.
b/ Cadres and civil servants defined in the law on cadres and civil servants, including:
- Cadres who are elected, approved or appointed to hold term-based certain posts or titles in Party and state agencies, central and local socio political organizations, are on payrolls and salaried by the state budget;
- Civil servants who are recruited or appointed to certain ranks, posts or titles in Party and State agencies and central, provincial- and district-level socio-political organizations; civil servants other than officers or professional army men; defense workers in agencies and units under the Ministry of National Defense; cadres and civil servants other than officers or professional non-commissioned officers working in agencies and units of the People’s Public Security force and in leading and managerial apparatuses of Party and State public non-business units or political organizations, are on payrolls and salaried by the state budget;
- Commune, ward and township cadres who are elected to hold term-based certain posts in the standing boards of People’s Councils, People’s Committees, secretaries or deputy secretaries of party committees and heads of socio-political organizations; commune-level civil servants who are recruited to hold professional titles under commune-level Peoples Committees.
c/ Part-time officials in communes, wards and townships under the law on cadres and civil servants.
2. Officers and non-commissioned officers, technical officers and non-commissioned officers, and non-commissioned officers, and soldiers who are serving in the People’s Public Security force for a definite period.
3. People on pension or monthly working capacity loss allowance.
4. People on monthly social insurance allowances for labor accident or occupational disease.
5. People who have stopped receiving working capacity loss allowance and are enjoying monthly allowances from the state budget; retired rubber workers who enjoying monthly allowances under Decision No. 206/CP dated May 30, 1979, of the Government Council (now the Government).
6. Retired commune, ward and township cadres who are enjoying monthly social insurance allowances.
Retired commune, ward and township cadres who are enjoying monthly allowances from the state budget, including entities defined in Decision No. 130/CP dated June 20, 1975, of the Government Council (now the Government), and Decision No. 111/HDBT dated October 13, 1981, of the Council of Ministers (now the Government).
8. People on unemployment allowance under the law on unemployment insurance.
9. People with meritorious services to the revolution under the law on preferential treatment towards people with meritorious services to the revolution.
10. War veterans who participated in resistance wars on or before April 30, 1975, under Clause 6, Article 5 of the Government's Decree No. 150/2006/ND-CP dated December 12, 2006, detailing and guiding a number of articles of the Ordinance on War Veterans; youth volunteers in the anti-French resistance war period under the Prime Minister’s Decision No. 170/2008/QD-TTg dated December 18, 2008, on health insurance benefits and funeral allowances for youth volunteers in the anti-French resistance war period.
11. People who personally participated in the anti-US resistance war for national salvation under the Prime Minister’s Decision No. 290/2005/QD-TTg dated November 8, 2005, on regimes and polis towards people that personally participated in the ANTI-US resistance war for national salvation but have not yet enjoyed Party or State policies, and the Prime Minister’s Decision No. 188/2007/QD-TTg dated December 6, 2007, supplementing and amending the Prime Minister’s Decision No. 290/2005/QD-TTg dated November 8, 2005, on regimes and policies towards people that personally participated in the anti-US resistance war for national salvation but have not yet enjoyed Party or State policies.
12. Incumbent deputies of the National Assembly and People’s Councils at all levels.
13. People on monthly social relief allowance under the Government’s Decree No. 67/2007/ND-CP dated April 13, 2007, guiding support policies towards social relief beneficiaries.
14. Poor household members; ethnic minority people living in areas with difficult or exceptionally difficult socio-economic conditions under the Prime Minister’s regulations.
15. Relatives of people with meritorious services to the revolution under the law on preferential treatment towards people with meritorious services to the revolution.
16. Relatives of persons defined at Points a, b and c, Clause 16, Article 12 of the Law on Health Insurance.
17. Under-6 children.
18. People who have donated their body organs under the law on donation, removal and transplantation of tissues and human organs and donation and recovery of cadavers.
19. Foreign students in Vietnam who are granted scholarships from the Vietnamese State’s budget.
20. Members of households living just above the poverty line under the Prime Minister’s regulations.
21. Pupils and students who are studying at educational institutions within the national education system.
22. Members of agricultural, forestry, fishery and salt-making households.
23. Relatives of laborers defined in Clause 1, Article 12 of the Law on Health Insurance, including blood parents; parents-in-law; adoptive parents or lawful fosterers; spouses; blood children and lawfully adopted children whom laborers are obliged to rear and who live together in the same households.
24. Members of cooperatives or individual business households.
25. Retired laborers who are enjoying sickness allowances under the law on social insurance as they suffer from diseases on Health Minister-promulgated list of diseases which need long-term treatment.
Article 2.
Health insurance premium rates and reductions, and determination of state budget supports for health insurance premium payment
1. Health insurance premium rates, methods of paying, and responsibility of entities to pay, health insurance premiums comply with Articles 13 and 14 of the Law on Health Insurance and Articles 3 thru 6 of Decree No. 62/2009/ND-CP.
2. When the State adjusts the minimum wage level, those who are defined in Clauses 20 thru 24, Article 1 of this Circular and have paid health insurance premiums on a biannual basis or a lump sum for the whole year are not required to additionally pay the difference as a result of such adjustment.
3. To reduce health insurance premiums under Clause 6, Article 3 of Decree No. 62/2009/ND-CP as follows:
a/ Those defined in Clauses 20 and 22, Article 1 of this Circular are entitled to the reduction of health insurance premiums when all persons named in the household status book and living in the same house are insured.
b/ Those defined in Clause 23, Article 1 of this Circular are entitled to the reduction of health insurance premiums when two or more of their relatives are insured.
4. To decide on support levels and determination of state budget amounts used as support in case of reduction of health insurance premiums:
a/ Based on the local budget capacity and other mobilized sources, provincial-level People’s Committees may decide on the levels of support for health insurance premium payment for entities higher than the minimum support levels specified in Clause 5, Article 3 of Decree No. 62/2009/ND-CP.
b/ In case an insured is given by the State an amount as partial support for health insurance premium payment, such amount shall be calculated based on the specific health insurance premium to be paid by each household member.
Example: Mrs. As agricultural household has 3 members with average living standards and is entitled to 30% reduction of health insurance premiums. In 2010, all these 3 member’s pay health insurance premiums per household at the rate of 4.5% of the minimum wage (presuming that the minimum wage at this time is VND 650,000). The health insurance premium Mrs. A’s household has to pay and the state budget support for her household to pay health insurance premiums in 2010 will be determined as follows:
The total health insurance premium Mrs. A’s household has to pay is VND 663,390, consisting of:
- The premium to be paid by the first member at the rate of 4.5% of the minimum wage:
VND 650,000 x 4.5% x 70% x 12 months = VND 245,700
- The premium to be paid by the second member equal to 90% of that payable by the first member:
VND 245,700 x 90% = VND 221,130
- The premium to be paid by the third member equal to 80% of that payable by the first member:
VND 245,700 x 80% = VND 196,560
The total state-budget support for Mrs. A’s household to pay health insurance premiums is:
VND 663,390 x 30% : 70% = VND 284,310.
5. Each person may be insured in the capacity as only one category. If a person concurrently falls into different categories of the insured under Article 1 of this Circular, he/she shall pay health insurance premiums in the capacity as the first category in the order specified in Article 1 of this Circular.
Article 3.
Methods of paying and responsibility of some categories of the insured to pay health insurance premiums
1. For those defined in Clauses 14, 17 and 18, Article 1 of this Circular:
a/ Based on the number of health insurance cards already issued to these persons, social insurance agencies of provinces or centrally run cities (below referred to as provincial-level social insurance agencies) shall sum up and send it to provincial level Finance Departments for the latter to transfer funds into the health insurance fund under Clause 9 of this Article.
b/ By December 31 every year at the latest, provincial-level social insurance agencies shall sum up number of health insurance cards valid in the year and support funds for payment of health insurance premiums and send them to provincial-level Finance Departments for payment and finalization under regulations (according to Appendix 1 to this Circular).
2. For those defined in Clause 20, Article 1 of this Circular:
a/ Biannually or annually, members of households living just above the poverty line shall pay their payable amounts of health insurance premium to social insurance agencies;
b/ Biannually or annually, provincial-level social insurance agencies shall sum up the number of issued health insurance cards, actually collected amounts and projected state budget supports and send them to provincial-level Finance Departments for the latter to transfer funds into the health insurance fund under Clause 9 of this Article.
3. For those defined in Clause 21, Article 1 of this Circular who are studying at educational institutions within the national education system (below referred to as schools):
a/ Biannually or annually, schools shall collect health insurance premiums from pupils and students and pay them to social insurance agencies;
b/ State budget supports for health insurance premium payment are specified as follows:
- For pupils and students studying at locally managed schools: Social insurance agencies shall sum up the number of issued health insurance cards, amounts actually collected from pupils and students and proposed state budget supports, then send them to district-level finance agencies or
provincial-level Finance Departments (according to local budget decentralization) for the latter to provide support funds under Clause 9 of this Article;
- For pupils and students studying at schools managed by ministries or central agencies; Vietnam Social Security shall sum up the number of issued health insurance cards, amounts actually collected from pupils and students and proposed state budget supports, then send them to the Ministry of Finance for the latter to provide support funds under Clause 9 of this Article.
4. For those defined in Clause 22, Article 1 of this Circular:
a/ Biannually or annually, members of agricultural, forestry, fishery and salt-making households shall pay health insurance premiums directly to social insurance agencies.
b/ For members of households with average living standards:
- Biannually or annually, they shall pay their payable amounts directly to social insurance agencies.
- Biannually or annually, provincial-level social insurance agencies shall sum up the number of issued health insurance cards, actually collected amounts and proposed state budget supports, then send them to provincial-level Finance Departments for the latter to transfer funds to the social insurance fund under Clause 9 of this Article.
5. For those defined in Clause 23, Article 1 of this Circular:
a/ Employees shall list their relatives and send the lists to their employers for registration to buy health insurance cards;
b/ Based on the registered lists of relatives of employees, employers shall monthly deduct from salaries or wages of employees for remittance into the health insurance fund together with health insurance premiums paid by employees.
6. For those defined in Clause 24, Article 1 of this Circular:
Biannually or annually, they shall pay health insurance premiums directly to social insurance agencies.
7. For those defined in Clause 25, Article 1 of this Circular:
Social insurance agencies shall pay monthly health insurance premiums for these persons. Vietnam Social Security shall annually sum up lists of the insured who have been issued health insurance cards and their payable health insurance premiums and send them to the Ministry of Finance for the latter to transfer funds to the social insurance fund.
8. For commune, ward and township part-time officials defined at Point c, Clause 1, Article 1 of this Circular:
Commune, ward or township People’s Committees shall pay monthly health insurance premiums for these officials and deduct health insurance premiums from their monthly allowances for simultaneous payment into the health insurance fund.
9. For finance agencies at all levels:
In the first month of every quarter, based on health insurance premiums paid for those defined in Clauses 14, 17, 18 and 25, Article 1 of this Circular and support amounts for health insurance premium payment for those specified in Clauses 20 and 21, and those defined in Clause 22, Article 1 of this Circular with average living standards, finance agencies at all levels shall transfer funds to the social insurance fund managed by social insurance agencies of the same level.
10. Those defined in Clauses 1, 2 and 16, Article 1 of this Circular who are managed by the Ministry of National Defense, the Ministry of Public Security or the Government Cipher Committee shall comply with separate guiding documents.
Article 4.
State budget funds used to wholly or partially pay health insurance premiums
1. The central budget shall wholly or partially pay health insurance premiums for the for the following categories of the insured:
a/ It shall wholly pay health insurance premiums for those defined in Clauses 1 and 2, Article 1 of this Circular (funds payable by employers whose regular activities are wholly or partially financed by the central budget) according to current state budget decentralization;
b/ It shall wholly pay health insurance premiums for those defined in Clauses 3, 4 and 5, Article 1 of this Circular (who enjoy state budget allocations) and in Clauses 9, 15, 16, 19 and 25, Article 1 of this Circular;
c/ It shall partially pay health insurance premiums for those defined in Clause 21, Article 1 of this Circular who are studying at schools managed by ministries or central agencies.
2. Local budgets shall wholly or partially pay health insurance premiums for the following categories of the insured:
a/ It shall wholly pay health insurance premiums for those defined in Clauses 1 and 2, Article 1 of this Circular (funds payable by employers whose regular activities are wholly or partially financed by local budgets) according to current state budget decentralization;
b/ It shall wholly pay health insurance premiums for those defined in Clauses 7, 10, 11, 12, 13, 14, 17 and 18, Article 1 of this Circular;
c/ It shall partially pay health insurance premiums for those defined in Clause 20, Article 1 of this Circular; those defined in Clause 21, Article 1 of this Circular who are studying at locally managed schools; and those defined in Clause 22, Article 1 of this Circular who have average living standards.
For localities which cannot themselves balance their budgets and are provided with the central budget's financial allocations as support in implementation of health insurance regulations, competent agencies shall decide on specific support levels.
3. Annually, while making state budget estimates, agencies, organizations and units managing the insured shall make budget estimates for whole or partial payment of health insurance premiums for them according to current state budget management decentralization. Specifically:
a/ At the central level:
- Employers whose regular activities are wholly or partially financed by the central budget shall make budget estimates for whole payment of health insurance premiums for those defined in Clauses 1 and 2, Article 1 of this Circular (health insurance premiums payable by employers).
- Vietnam Social Security shall make budget estimates for whole payment of health insurance premiums for those defined in Clauses 3, 4 and 5 (who have their health insurance premiums paid by the state budged and those defined in Clause 25, Article 1 of this Circular; and partially pay health insurance premiums for those defined in Clause 21, Article 1 of this Circular who are studying at schools managed by ministries or central agencies (including schools of enterprises of all economic sectors).
- The Ministry of Labor, War Invalids and Social Affairs shall make budget estimates for whole payment of health insurance premiums for those defined in Clauses 9 and 15, Article 1 of this Circular.
The Ministry of National Defense, the Ministry of Public Security and the Ministry of Home Affairs shall make budget estimates for whole payment of health insurance premiums for those defined in Clause 16, Article 1 of this Circular.
- Scholarship-granting agencies, organizations and units shall make budget estimates for whole payment of health insurance premiums for those defined in Clause 19, Article 1 of this Circular.
b/ At the local level:
- Employers whose activities are wholly or partially financed by local budgets shall make budget estimates for whole payment of health insurance premiums for those defined in Clauses 1 and 2, Article 1 of this Circular (health insurance premiums payable by employers).
- Labor, War invalids and Social Affairs agencies shall make budget estimates for whole payment of health insurance premiums for those defined in Clauses 10, 11, 13, 14 and 17, Article 1 of this Circular; and partially pay health insurance premiums for those defined in Clause 20, and those defined in Clause 22, Article 1 of this Circular who have average living standards.
- Social insurance agencies shall make budget estimates for whole payment of health insurance premiums for those defined in Clause 18, Article 1 of this Circular; and partially pay health insurance premiums for those defined in Clause 21, Article 1 of this Circular who are studying at locally managed schools (including schools of enterprises of all economic sectors).
- Provincial-level People’s Councils shall make budget estimates for whole payment of health insurance premiums for National Assembly deputies of local delegations of National Assembly deputies. People’s Councils at each level shall make budget estimates for whole payment of health insurance premiums for their deputies.
- Commune-level People’s Committees shall make budget estimates for whole payment of health insurance premiums for those defined at Point c, Clause 1, and Clause 7, Article 1, of this Circular.
Chapter Il
PAYERS AND RATES OF, AND METHODS OF PAYING, HEALTH INSURANCE PREMIUMS ON A VOLUNTARY BASIS
Article 5.
Payers
1. Payers of health insurance premiums on a voluntary basis defined in Article 51 of the Law on Health Insurance and Clause 2, Article 2 of Decree No. 62/2009/ND-CP include:
a/ Part-time officials in communes, wards and townships under the law on cadre and civil servants;
b/ Retired laborers who are enjoying sickness allowances under the law on social insurance as they suffer from diseases on the Health Ministry-promulgated list of diseases which need prolonged treatment;
c/ Pupils and students studying at schools, except those insured of other categories;
d/ Members of agricultural, forestry, fishery and salt-making households;
e/ Relatives of laborers who are salary and wage earners under the law on salaries and wages; members of cooperatives and individual business households.
2. Those defined at Points a, d and e, Clause 1 of this Article shall be determined based on administrative boundaries; those defined at Points b and c, Clause 1 of this Article shall be determined based on their agencies and schools.
3. Vietnam Social Security shall specifically guide the issuance of health insurance cards to the insured, ensuring non-interruption upon shifting from voluntary payment of health insurance premiums to compliance with the Law on Health Insurance.

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