The procedure for changing your primary healthcare provider includes several steps and is considered a basic yet essential process. Let’s explore the steps involved in changing your primary healthcare provider
1 When can you change your primary healthcare provider?
Individuals with health insurance are allowed to change their primary healthcare provider at the beginning of each quarter.
As per Article 26 of the 2008 Health Insurance Law: “Health insurance participants are allowed to change their registered primary healthcare facility at the beginning of each quarter.”
Consequently, any changes to your primary healthcare provider can only be made during the months of January, April, July, and October.
2 What is the procedure for changing your primary healthcare provider?
The process of changing your primary healthcare provider involves submitting specific documents.
According to the 2008 Health Insurance Law, individuals with health insurance are permitted to change their primary healthcare facility when necessary.
As outlined in Clause 4, Article 27 of Decision 595/QD-BHXH, the required documents for changing your primary healthcare provider include the following:
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Declaration form for participation and information adjustment for social insurance and health insurance (for health insurance participants)
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Information sheet (for units)
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Additionally, you will need to submit your old health insurance card, which must still be valid for use.
3 Are there any costs involved in changing your primary healthcare provider?
There are no costs associated with changing your primary healthcare provider.
Clause 3, Article 30 of Decision 595/QD-BHXH states that there are no fees involved in the procedure for reissuing a health insurance card due to a change in the primary healthcare provider.
4 How long does it take to process the change of primary healthcare provider application?
The new health insurance card will be issued within 3 working days from the date of submitting a complete application.
Clause 3, Article 30 of Decision 595/QD-BHXH specifies that the application process for changing the primary healthcare provider should not exceed 3 working days from the date of receiving a complete application.
According to Clause 1, Article 19 of the 2008 Health Insurance Law, amended and supplemented in 2014, the procedure for changing the primary healthcare provider includes the following steps:
Step 1: Prepare the required documents
The documents needed for changing your primary healthcare provider are as follows:
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Declaration form for providing and changing information of social insurance and health insurance participants, following form TK1-TS (1 copy)
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Old health insurance card that is still valid for use
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Identity card (original and 1 copy)
Step 2: Submit the application for changing your primary healthcare provider
You can submit your application for changing your primary healthcare provider at the beginning of each quarter.
The application can be submitted at the following locations:
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Social Insurance Agency at the district level: For issuing new cards, reissuing, or replacing health insurance cards for individuals whose insurance is collected by the district-level agency.
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Social Insurance Agency at the provincial level: For issuing new cards, reissuing, or replacing health insurance cards for individuals whose insurance is directly collected by the provincial-level agency.
Step 3: Wait for the application to be processed
You can submit your application and receive a receipt or notification via email from the Social Insurance Agency where you submitted your application (if done through the Social Insurance electronic system).
The new health insurance card will be issued within 3 working days from the date of submitting a complete application. If the application cannot be processed, the Social Insurance Agency must provide a clear reason for the rejection.
Step 4: Receive your new health insurance card with the updated primary healthcare provider
The Social Insurance Agency will send the new health insurance card with the changed primary healthcare provider to the participant or to the unit where the application for changing the primary healthcare provider was made.
5 Where can I submit the application to change my primary healthcare provider?
The application for changing your primary healthcare provider can be submitted to different authorities based on your insurance type.
According to Clause 3, Article 3 of Decision 595/QD-BHXH on the issuance of health insurance cards, the submission of the application depends on the type of insurance and the collecting authority:
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For individuals with health insurance collected by the district-level Social Insurance Agency, the application should be submitted to the district-level Social Insurance Agency.
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For individuals with health insurance collected directly by the provincial-level Social Insurance Agency, the application should be submitted to the provincial-level Social Insurance Agency.
6 What to do if you need medical attention while waiting for your new health insurance card?
You can still receive medical attention while waiting for your new health insurance card by presenting the required documents.
Clause 3, Article 15 of Decree 146/2018/ND-CP stipulates the following regarding medical attention while waiting for a new or replacement health insurance card:
“Individuals with health insurance who are waiting for their new or replacement health insurance card to be issued must present the appointment slip for the new or replacement card, issued by the social insurance agency or the organization/individual authorized by the social insurance agency to receive the application for the new or replacement card according to Form 4 in the Appendix attached to this Decree, along with a form of personal identification.”
Therefore, individuals with health insurance can still enjoy the benefits of their insurance as per the regulations if they can present the appointment slip for the new or replacement health insurance card along with their identification documents.
We have shared with you the procedure for changing your primary healthcare provider. If you intend to change your primary healthcare provider, please refer to this article.
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