Tam Binh Checklist: Before You Buy and When You Need to Claim

Buying health insurance only to discover a missing document — or being shocked to find you’re not covered — is a very common worry. This article compiles the Bao Viet Tam Binh checklist in two parts: before you buy and when you need to use your benefits, so you can quickly tick off each item before signing and before submitting your file.

📋 Checklist before you buy Bao Viet Tam Binh

The product applies to individuals, households and organizations with fewer than 3 employees, with a 12-month policy term. Before signing the insurance application, check each item below:

• Confirm the right program: the five programs — Basic (Cơ bản), Extended (Mở rộng), Advanced (Nâng cao), Comprehensive (Toàn diện) and Superior (Ưu việt) — carry inpatient sums insured of VND 60, 100, 160, 220 and 330 million per person per year respectively. Compare the limits of each benefit carefully before choosing; see how the 5 Tam Binh plan tiers differ.
• Check the detailed limits: each program caps daily room charges (from VND 400,000 to 2,000,000), allows up to 60 days of hospitalization per year, and sets separate caps for special surgery, childbirth surgery, other surgery, the daily hospitalization allowance, pre- and post-hospitalization visits, ambulance and education support (up to 2 children).
• Choose the right add-ons: you may pick only 1 of 2 — Personal Accident or Life & Personal Accident — plus the Outpatient treatment benefit if needed. Death and total permanent disability sums range from VND 20–100 million depending on the program.
• Review the waiting periods: accidents take effect immediately; for ordinary illness, 30 days for inpatient and 30 days for outpatient; pre-existing conditions, special illnesses, and ligament/meniscus tear, rupture or reconstruction: 365 days; maternity complications: 90 days; childbirth: 635 days; cancer: 730 days. Details for each case are in Tam Binh’s waiting periods explained.
• Declare your health honestly: answer all 4 questions on your medical history over the past 3 years, your current treatment status, serious illnesses you have had, and any history of insurance rejection. You must undertake that you are currently in full health, with no permanent disability of 80% or more. See the guide on health declaration for Tam Binh.
• Check the eligibility and participation conditions for each insured person, including foreigners, and confirm the form of hospital fee guarantee (direct billing) card — physical or electronic — and the guarantee scope (public hospitals or the whole system), if applicable.
• Compare the premium table by age band for each program before paying, noting that the premium is calculated on the total of the benefits you join.
• Remember the general payment limits: Traditional medicine (Đông y) methods are paid up to 50% of the corresponding sum insured; benefits for cancer and related complications or consequences (after a 2-year waiting period, i.e. from the 3rd year of continuous participation) are paid up to 50%; children aged from 15 days to 3 years are subject to a 70/30 co-payment ratio, except for treatment at public medical facilities or hospitals (excluding international wards, voluntary or request-based treatment departments).

🗂️ Checklist when you need to use your benefits

When visiting a clinic or hospital, preparing correctly from the start makes your claim file smoother:

• Confirm the treatment facility is covered: especially for dental — in Ho Chi Minh City and Hanoi, dental benefits are paid at all hospitals, while clinics must have a payment-guarantee cooperation agreement with Bao Viet; in other provinces and cities, benefits are paid at all hospitals and at dental clinics or clinics as defined. The list of facilities with agreements is updated on Bao Viet’s official website.
• Check that the waiting period for the condition being treated has passed before expecting any payment.
• Keep all invoices and payment receipts (prefer e-invoices — the electronic equivalent of the VAT red invoice, with a verification link) and medical documents: discharge summary, test results, diagnostic imaging, prescriptions and doctor’s instructions.
• Keep the detailed itemized bill to cross-check against per-item limits (room, surgery, tests, medical supplies…).
• For accidents, prepare an accident statement and documents related to the incident.
• Submit your file on time and at the designated place; if you have been issued a guarantee card, you can use hospital fee guarantee or submit soft claim files via the BaoViet Direct app for claims that are not inheritance and are VND 10,000,000 or less.
• Track progress: where hospital fee guarantee is not used, the insurer settles and pays by cash or bank transfer within 15 working days from the date it receives the complete, valid claim request.
• Prepare a plan in case you need to cancel: if the policyholder requests termination, 70% of the premium for the remaining coverage period is refunded, provided no insurance payment request has been accepted; if the insurer requests termination, the full premium for the remaining period is refunded. See how much refund you get when cancelling Tam Binh.

💡 Final notes

Read the insurance rules, benefits table and exclusions carefully before signing, as the detailed content is governed by the Bao Viet Tam Binh Insurance Rules attached to the contract. Each contract may have its own acceptance conditions, so any questions about limits, waiting periods or specific exclusions should be checked directly in the contract set or with a Bao Viet advisor.

Health insurance is an important piece of protection in your family’s financial plan — take a few minutes to go through the Bao Viet Tam Binh checklist above each time you buy a new policy or renew, so your benefits are always ready when you need them.