With the development of society today, there are many people who often participate in many types of health insurance. This leads to participants having duplicate health insurance. So if in case the user pays the same amount of health insurance, will they get a refund?
1. Health insurance participants belong to many different groups
Everyone knows that participating in health insurance is a form of mandatory regulation. Health insurance participants will participate to take care of their health. And this health insurance is not for profit purposes organized by the State for the people.
When health insurance participants belong to too many different subjects. These subjects have been clearly stated in Clause 4, Article 7 of Decree 146/2018/ND-CP. As follows:
These people will pay health insurance based on the following order: health insurance is paid directly by employees and employers; Health insurance is paid by the social insurance agency; Health insurance is paid by the State budget; Health insurance is paid by the employer.
If the employee belongs to too many different health insurance participants and also pays the same health insurance. Duplicate payers can receive a full refund of the paid amount.
2. Refund duplicate health insurance premiums to participants
In Clause 2.5 of Article 2 of Decision 595/QD-BHXH 2017 on refunding health insurance to participants. Refund is where the social insurance agency returns the entire amount to the payer. That amount is determined not to be a health insurance premium. Or this amount is the excess payment when the participant has stopped transactions with the social insurance agency. Or this person pays the same amount as the agency, unit or individual that has filed with the health insurance agency.
If the health insurance participant belongs to the subjects supported by the State budget. Or these people have participated in health insurance based on the household form. These subjects will all receive a refund if:
- Health insurance participants who have been issued health insurance cards are a new target group. And that day came the notice of reduction in the value of the previously issued card.
- This person is adjusted by the State budget to increase the level of support for health insurance contributions.
- The participant died before his/her health insurance was valid.
3. Target groups supported by health insurance
For groups, the entire contribution level is supported by the state budget
– People in near-poor households, people in agricultural, forestry or fishery households. Households belong to the salt industry and these households all have an average standard of living.
Groups of people participating in health insurance by household
– Includes all people whose names are in the family’s household registration. All people whose names are in the temporary residence book, except those who have declared temporary absence.
4. Conclusion
– When based on the above regulations, when the health insurance participant pays the same health insurance. Reimbursement of health insurance for duplicate contributors only occurs when one person participates in household health insurance. Furthermore, this person must also be issued a health insurance card as a new subject.
– In Article 20 of Decision 595, the amount of duplicate health insurance contributions paid to participants will be calculated as follows. Based on the health insurance premium and the entire period for which this participant pays. But according to the request, this person has not used the card.
– If you have paid health insurance for a period of time but have not used the card. It will be calculated from the moment this participant is granted group health insurance that begins to be valid. And also those who have been issued health insurance cards based on the new group of subjects but have so far reported a reduction in the value of using the previously issued cards.
Thus, when participants pay the same amount of health insurance, they will still receive a refund. But only with the condition that this health insurance participant meets all of the conditions stated above will be refunded.
