Law amending and supplementing a number of articles of the Law on Health Insurance: Increasing benefits for health insurance participants

From July 1, 2025, the Law amending and supplementing a number of articles of the Law on Health Insurance (HI) officially takes effect, with some provisions taking effect early from January 1, 2025. The Law adds a number of new points to expand the rights of HI participants, contributing to improving the quality of health care for the entire population.

People with rare and serious diseases do not need a referral letter and enjoy 100% health insurance.

From January 1, 2025, health insurance participants will enjoy 100% of the benefits when examining and treating at basic or specialized health care facilities in cases of confirmed diagnosis and treatment of certain rare diseases, serious diseases, diseases requiring surgery or using advanced technology according to regulations of the Minister of Health . Thus, in cases where patients have been diagnosed with rare diseases, serious diseases or diseases requiring the use of advanced technology (belonging to the list of 62 groups of rare diseases issued by the Ministry of Health), they can go directly to specialized health care facilities without having to request a referral form to a health insurance facility. This flexibility helps patients access more appropriate and timely medical services.

Mr. Nguyen Van X. in Phuong Nam commune ( Hung Yen city) shared: I am being treated for a malignant brain tumor at a central hospital. Before, every time I went to a higher level hospital for treatment, I had to ask for a referral letter. Now I can go directly to a higher level hospital and still have health insurance cover my treatment costs, I feel very secure.

Providing health insurance services regardless of administrative geography

The Law amending and supplementing a number of articles of the Law on Health Insurance stipulates the level of health insurance benefits when implementing universal health insurance services in the direction of not distinguishing between administrative boundaries by province, maintaining the stable rate of health insurance benefits according to the provisions of the current Law on Health Insurance and expanding it to a number of cases.

Accordingly, health insurance participants are entitled to 100% of the benefits when receiving medical examination and treatment at initial health insurance facilities nationwide; 100% of the benefits when receiving inpatient medical examination and treatment at basic health insurance facilities nationwide; 100% of the benefits when receiving medical examination and treatment at any basic or specialized health insurance facility that is determined by the competent authority to be at the district level before January 1, 2025. The Law expands a number of benefits for health insurance card holders, including treatment of strabismus and refractive errors of the eyes for people under 18 years old; Supplementing the mechanism for payment of drugs and medical equipment transferred between medical facilities and payment of paraclinical service costs transferred to other facilities in case of shortage of drugs and medical equipment and regulating the mechanism for the health insurance fund to pay for these cases... Ms. Luc Thi Thu Thuy in Ban Yen Nhan ward (My Hao town) expressed: These new regulations create convenience for health insurance participants when they have health problems.

Add more groups of subjects required to participate in health insurance

The Law amending and supplementing a number of articles of the Law on Health Insurance adds groups of subjects required to participate in health insurance, including: Employees with labor contracts of 1 month or more; foreigners working in Vietnam with work permits or practice certificates... This expansion helps increase the rate of health insurance coverage so that all people have access to quality health services, contributing to ensuring social security for all workers and people in all localities. According to the provisions of the law, the health insurance contribution rate is also adjusted with the contribution rate determined according to the percentage of salary or the reference level prescribed by the Government. This adjustment is aimed at creating fairness and consistency with the income of participants.

Carry out procedures for registering for health examination and treatment under health insurance at Van Giang District Medical Center

Ensure the rights of participants

New points in the Law amending and supplementing a number of articles of the Law on Health Insurance aim to protect and improve public health, while creating favorable conditions for both people and medical facilities to participate in and provide health insurance services. By the end of May 2025, Hung Yen province had nearly 1.17 million people participating in health insurance, reaching 95% of the plan assigned by the Vietnam Social Security. To effectively implement the Law, the Social Security agency has promoted direct and online communication to bring the policy closer to the people. In addition, the Social Security agency continues to review and simplify administrative procedures in implementing health insurance policies; strengthen digital transformation, complete and connect specialized data systems, national databases on health insurance to create favorable conditions for health insurance participants and health insurance examination and treatment, especially the elderly, children, people with disabilities, etc. At the same time, strictly appraise health insurance examination and treatment costs; Payment and settlement of health insurance examination and treatment costs in accordance with regulations, ensuring the rights of participants...