Key Updates to Vietnam’s Health Insurance (HI) Policy: How Will Participants’ Benefits Change?

Effective 1 July 2026, several new regulations governing Vietnam’s Health Insurance (HI) scheme officially came into force under the Law on Amendments to the Law on Health Insurance 2024, Decree No. 188/2025/ND-CP, Decree No. 161/2026/ND-CP, and Circular No. 01/2025/TT-BYT. These changes focus on expanding participants’ benefits while updating contribution rates and reimbursement thresholds in line with the new statutory base salary.

Expanded Benefits for Self-Referred Outpatient Medical Examination and Treatment

From 1 July 2026, HI participants who seek outpatient medical examination and treatment without a referral at certain primary-level and specialized healthcare facilities will be eligible for reimbursement from the Health Insurance Fund in accordance with applicable regulations.

Specifically, in addition to continuing to receive 100% reimbursement for medical examination and treatment related to rare diseases, severe illnesses, and conditions requiring highly specialized treatment as prescribed by the Ministry of Health, participants will also be entitled to 50% reimbursement of eligible expenses for other diseases and medical conditions not covered under Circular No. 01/2025/TT-BYT (pursuant to Clause 4, Article 22 of the Law on Amendments to the Law on Health Insurance No. 51/2024/QH15 and Article 19 of Decree No. 188/2025/ND-CP).

This represents a significant patient-centered reform, expanding healthcare benefits and making medical services more accessible for Health Insurance participants.

Adjustable threshold payment of 100% of the cost of medical treatment according to the salary basis new

Under Decree No. 161/2026/ND-CP, effective 1 July 2026, Vietnam’s statutory base salary applicable to public officials, civil servants, public employees, and members of the armed forces increases from VND 2,340,000 to VND 2,530,000 per month. This adjustment results in corresponding changes to both Health Insurance contribution rates and reimbursement thresholds.

Under the provisions of the Law on health INSURANCE, the insured continues to be the health INSURANCE fund paid 100% of the cost of medical treatment in case of total cost of one exam, cure lower than 15% of the basic salary (equivalent 379.500 copper). At the same time, the insured 5 consecutive years and above will be funds to pay 100% of the cost in the range effect when the same amount of pay during the year exceeds 6 times the basic salary (equivalent 15.180.000 copper).

The level of payment for some service technicians also be adjusted. In that case, the insured is only to perform the service technique, then the health INSURANCE fund paid the total cost of medical equipment for one-time use technical service does not exceed 45 months wage base (equivalent 113,850.000).

Boost converter numbers in medical health insurance

In parallel with the completion of the policy, The insurance industry Vietnamese society continues to promote the transformation of, a data connection with the Medical industry, creating conditions for people to use the id citizens mount chip, application VssID or VNeID replace health INSURANCE cards paper when to go to the clinic, healing. The synchronization of data between agencies not only help simplify administrative procedures, but also contribute to improving the quality of service, reduce waiting time of patients.

Adjust the level of health insurance contributions by households and objects students

The adjustment of the salary basis in the Decree no. 161/2026/ND-CP also changes the health INSURANCE of the group object that the contribution calculated according to the salary base, including the health INSURANCE participation by households and students. 

Base clause 4, Article 6 of the Decree 188/2025/ND-CP, the health INSURANCE monthly of students by 4.5% of the basic salary. Accordingly, the health INSURANCE for students is 113.850/month (equivalent 1.366.200/year). Although the health INSURANCE students increase in salary new facility, but thanks to policy support support a minimum of 50% from the state budget, school, student, only to close maximum 631.800/year.

Pursuant to paragraph 5 of Article 6 of the Decree 188/2025/ND-CP, the health insurance your monthly household defined as follows: the first closed by 4.5% of the basic salary; the Monday, Tuesday, Wednesday, close up, turn 70%, 60%, 50% level of the second; from the second year onwards by 40% contribution rate of the first. From date 01/07/2026, the health INSURANCE household of the person is 113.850/month (equivalent 1.366.200/year), the Monday is 79.695/ month (equivalent 956.340/year), who Tuesday is 68.310/ month (equivalent 819.720/year), the fourth is 56.925/month (equivalent 683.100/year); from the second year onwards is 45.540/month (equivalent 546.480/year).

The policy on health INSURANCE valid from date 01/07/2026 continue to follow the direction of extension benefits, simplify the procedure and adjust the contribution rate, the benefit level in accordance with the wage base new. Combined with the boost converter number has been helping people by simplifying administrative procedures and access easier when using health insurance. This is the important step to realize the goal of universal health INSURANCE coverage, and contributing to social security, care for, protect, and improve people’s health in the new period.