What are latest levels of health insurance benefits in 2025? Is the cost of paying social insurance for employees deductible when calculating CIT in Vietnam?

What are regulations on the latest levels of health insurance benefits in Vietnam in 2025?

Pursuant to Article 22 of the 2008 Health Insurance Law, as amended and supplemented by Clause 17, Article 1 of the 2024 Amended Health Insurance Law, the health insurance benefits applicable from January 1, 2025, are as follows:

Individuals participating in health insurance, when seeking medical examination and treatment as per the provisions in Articles 26 and 27 of the 2008 Health Insurance Law, are eligible for reimbursement from the health insurance fund for medical expenses within the coverage scope at the following benefit levels:

(1) 100% Coverage

100% Coverage applies to the following groups:

- Active-duty officers of the People's Army, professional army officers; officers, non-commissioned officers of the People's Public Security; and individuals working in cryptography enjoying the salary equivalent to military personnel;

- Active-duty non-commissioned officers, soldiers of the People's Army; conscripted officers, soldiers in the People's Public Security; military students, police students, cryptography students receiving allowances who are Vietnamese citizens;

- Military students, police students, cryptography students receiving allowances who are foreigners;

- Students in officer reserve training for more than 3 months who have not participated in social insurance, health insurance;

- Permanent militia members;

- Individuals who have rendered meritorious services to the revolution according to the Ordinance on Preferences for Individuals with Meritorious Services to the Revolution; veterans;

- Children under 6 years old;

- Relatives of martyrs, individuals who have nurtured martyrs as per the Ordinance on Preferences for Individuals with Meritorious Services to the Revolution;

- Individuals from poor households; ethnic minorities from near-poor households residing in areas designated for ethnic minorities and mountainous regions; ethnic minorities residing in areas with difficult socio-economic conditions; individuals residing in areas with exceptionally difficult socio-economic conditions; individuals residing on island communes, island districts;

- Individuals receiving monthly social allowances; individuals receiving monthly nurturing allowances as prescribed by relevant laws; individuals receiving a monthly survivor's pension who are eligible for social allowances;

- Individuals aged 75 years or older receiving monthly survivor's pension, individuals aged 70 to under 75 years from near-poor households receiving monthly survivor's pension;

Additionally, 100% Coverage is applicable to:

- 100% of the cost of medical examination and treatment in cases where the cost per visit is below the threshold set by the Government of Vietnam;

- 100% of the cost of medical examination and treatment at facilities classified as primary care facilities, including health stations; family medicine clinics; military-civilian medical stations, military-civil clinics; district-level health centers with licensed outpatient clinics; healthcare agencies organized by the Minister of Health; or primary care facilities within the military or public security organized by the Minister of Defense or Minister of Public Security. 100% cost coverage for outpatient services at regional polyclinics;

- 100% of medical costs for individuals who have participated in health insurance for at least 5 years continuously, and whose out-of-pocket costs for medical care, as stipulated in Clause 3, Points a, b, c, d, and e of Clause 4, Clause 5, Article 22 of the 2008 Health Insurance Law, Article 26, and Article 27 of the 2008 Health Insurance Law, exceed six times the reference level;

(2) 95% Coverage

95% coverage of medical costs for individuals defined in Point a, Clause 2, Point k, Clause 3, Points a and g, Clause 4 of Article 12 of the 2008 Health Insurance Law;

(3) 80% Coverage

- 80% coverage of medical costs for other individuals.

Note:

- Individuals eligible under multiple categories for health insurance participation will receive benefits based on the category with the highest benefits.

- Individuals who self-refer for medical examinations or treatments not at registered primary care facilities, or non-compliant with referral policies as specified in Articles 26 and 27 of the 2008 Health Insurance Law, will be reimbursed by the health insurance fund according to the percentage rates of coverage as follows:

+ 100% coverage for examinations and treatments at primary or specialized care facilities for diagnoses or treatments of rare, critical conditions, or high-tech procedures as determined by the Minister of Health;

+ 100% coverage for ethnic minorities and individuals from poor households residing in areas with difficult or exceptionally difficult socio-economic conditions, or living on island communes or districts when receiving inpatient care at specialized care facilities;

+ 100% coverage for examinations and treatments at initial care facilities;

+ 100% coverage for inpatient care at primary care facilities;

+ 100% coverage for examinations and treatments at primary or specialized care facilities that, before January 1, 2025, were designated as district-level facilities by competent authorities;

+ 50% to 100% coverage for outpatient care at primary care facilities based on professional technical rankings and specific reimbursement percentages set by the Government of Vietnam;

+ 40% coverage for inpatient care at specialized care facilities;

+ 50% coverage for outpatient care as determined by the Government of Vietnam and 100% coverage for inpatient care at specialized care facilities that, before January 1, 2025, were designated as provincial-level facilities by competent authorities.

- Individuals participating in health insurance are entitled to 100% coverage in any facility in cases of emergency.

What are latest levels of health insurance benefits in 2025? Is the cost of paying social insurance for employees deductible when calculating CIT? (Image from Internet)

Is the health insurance contribution for employees deductible when calculating CIT in Vietnam?

Pursuant to Article 6 of Circular 78/2014/TT-BTC as amended by Article 4 of Circular 96/2015/TT-BTC regarding deductible and non-deductible expenses when determining taxable income:

Deductible and Non-Deductible Expenses for Determining Taxable Income

1. Except for the non-deductible expenses mentioned in Clause 2 of this Article, enterprises can deduct all expenses if they meet the following conditions:

a) The actual expenses incurred related to the production and business activities of the enterprise.

b) The expenses have sufficient legal invoices and documents as prescribed by law.

c) The expenses, if involving invoices for goods or services valued at 20 million VND or above (including VAT), must be paid via non-cash payment methods.

...

2. Non-deductible expenses for determining taxable income include:

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Expenditure exceeding 3 million VND/month/person for contributions to voluntary pension funds, purchasing voluntary pension insurance, life insurance for the employee; Expenditure exceeding the legal limits for social insurance or health insurance for contributions to social security funds (mandatory supplementary pension insurance), health insurance fund, and unemployment insurance fund for employees.

Expenditures related to contributions to voluntary pension funds, social security-related funds, purchases of voluntary pension insurance, and life insurance for employees can be deducted beyond the limits stated at this point only if specified in one of the following documents: employment contracts; collective labor agreements; financial policies of the Company, Corporation, Group; bonus regulations determined by the Chairman of the Board, CEO, or Director in accordance with the Company's financial policies, Corporation, or Group.

Enterprises cannot include in costs any optional program expenses if they fail to fulfill mandatory insurance obligations for employees (including outstanding amounts for mandatory insurance).

...

According to the above provisions, costs related to the payment of health insurance for employees will be deductible when calculating CIT, provided they meet all the conditions:

- Actual expenses incurred relate to the production and business activities of the enterprise.

- Expenses have sufficient legal invoices and documents as prescribed by law.

- Expenses involving invoices for goods or services valued at 20 million VND or more (including VAT) must be paid via non-cash payment methods.

However, if the expenditure exceeds the legal limits for health insurance contributions to social security funds, it will not be considered a deductible expense when determining the taxable income for CIT.

Is the health insurance contribution from employees deductible when calculating PIT in Vietnam?

According to Clause 1, Article 21 of the 2007 Personal Income Tax Law, as amended by Clause 5, Article 1 of the 2012 Amended Personal Income Tax Law, regarding taxable income:

Taxable Income

1. Taxable income for earnings from business, salary, or wages is the total taxable income defined in Articles 10 and 11 of this Law, minus contributions to social insurance, health insurance, unemployment insurance, professional liability insurance in certain sectors or professions required to participate in mandatory insurance, voluntary pension funds, and other deductions provided in Articles 19 and 20 of this Law.

The Government of Vietnam prescribes the maximum deductible amount for contributions to voluntary pension funds as stated in this clause.

Thus, health insurance contributions from employees are included as deductible expenses when calculating PIT.