Health insurance coverage rate in Vietnam

00:36, 12/07/2024

Medical examination and treatment are essential needs of humans in daily life. Particularly, for those participating in health insurance, medical examination and treatment will enjoy the following benefits:

Classification	Entities	Coverage rate	Note
Appropriate-level health insurance	Officers, professional soldiers, officers, non-commissioned officers, and officers, non-commissioned officers with specialized, technical expertise, etc.	100%	- Costs for one medical examination, treatment lower than the level regulated by the Government of Vietnam and medical examination and treatment at the commune level. - Patients with continuous health insurance participation of 5 years or more and have a co-payment amount for medical examination, treatment in the year larger than 6 months' statutory pay rate, except for cases of self-medicated medical examination and treatment not in the correct route.
	People with meritorious services to the revolution, veterans
	Children under 6 years old
	Individuals entitled to monthly social protection allowance
	Members of poor households; ethnic minorities living in areas with difficult socio-economic conditions; people living in areas with especially difficult socio-economic conditions; people living on islands and island districts
	Relatives of those with meritorious services to the revolution, including fathers, mothers, spouses, or children of martyrs; individuals honoring and nurturing martyrs
	People receiving pensions, monthly loss of labor capacity allowance	95%
	Relatives of those with meritorious services to the revolution excluding fathers, mothers, spouses, or children of martyrs
	Members of near-poor households
	Other objects	80%
Inappropriate-level health insurance	Inpatient treatment at central-level hospitals	40%	Trường hợp điều trị ngoại trú vượt tuyến sẽ không được hưởng BHYT
	Inpatient treatment from January 1, 2015, to December 31, 2020	60%
	Inpatient treatment from January 1, 2021, nationwide at provincial-level hospitals	100%
	Medical examination and treatment from January 1, 2016, at district-level hospitals	100%
	Medical examination and treatment from January 1, 2015, to December 31, 2015	70%
Health insurance in case of referral	People with meritorious services to the revolution, veterans	100%	Individuals participating in health insurance when going for referral medical examination and treatment must have a valid referral file from the medical examination and treatment facility
	Children under 6 years old
	Individuals entitled to monthly social protection allowance
	Members of poor households; ethnic minorities living in areas with difficult socio-economic conditions; people living in areas with especially difficult socio-economic conditions; people living on islands and island districts
	Relatives of those with meritorious services to the revolution, including fathers, mothers, spouses, or children of martyrs; individuals honoring and nurturing martyrs
	Relatives of those with meritorious services to the revolution, EXCLUDING fathers, mothers, spouses, or children of martyrs
	Individuals active in the revolution before January 1, 1945; individuals active in the revolution from January 1, 1945, to the August 1945 Revolution uprising; Vietnamese Heroic Mothers; war invalids, individuals entitled to policies as war invalids, Class B invalids, and individuals decreasing labor capacity by 81% or more; war invalids, individuals entitled to policies as war invalids, Class B invalids, invalids when treating recurring injuries, and illnesses; Children under 6 years old
	Medical examination and treatment at the commune level
	People receiving pensions, monthly loss of labor capacity allowance	95%
	Relatives of those with meritorious services to the revolution, excluding fathers, mothers, spouses, or children of martyrs
	Members of near-poor households
	Medical examination and treatment for other objects	80%

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- This translation is generated by OpenAI's GPT-4o model;
- The legal regulations in this article are according to Vietnamese Law;
- This English translation is for reference purposes only and not a definitive translation of the original Vietnamese texts;
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