New regulations on subjects and levels of health insurance contributions

Quy định mới về đối tượng, mức đóng bảo hiểm y tế- Ảnh 1. — Decree No. 188/2025/ND-CP stipulates the subjects and levels of health insurance contributions.

In which, the Decree clearly stipulates the subjects, contribution levels, and support levels for health insurance contributions.

Health insurance participants

The Decree stipulates the subjects participating in health insurance as follows:

In addition to the subjects participating in health insurance as prescribed in Clauses 1, 2, 3, 4, 5 and 6, Article 12 of the Law on Health Insurance, health insurance participants also include the following subjects:

1- Rubber workers who are receiving monthly allowances according to Government regulations participate in group health insurance paid by the social insurance agency as prescribed in Clause 2, Article 12 of the Law on Health Insurance.

2- People in the revolutionary safe zone communes during the resistance war against France or America who are currently residing in the revolutionary safe zone communes during the resistance war against France or America have had their information updated in the National Population Database and the Residence Database participating in group health insurance funded by the state budget as prescribed in Clause 3, Article 12 of the Law on Health Insurance.

3- People who are awarded the title of People's Artist or Meritorious Artist belonging to households with an average monthly income per capita lower than the basic salary prescribed by the Government and are not subject to the provisions of Clauses 1, 2 and 3, Article 12 of the Law on Health Insurance shall participate in group health insurance paid by the state budget as prescribed in Clause 3, Article 12 of the Law on Health Insurance.

4- Victims of post-war bombs, mines and explosives as prescribed in Clause 8, Article 3 of Decree No. 18/2019/ND-CP dated February 1, 2019 of the Government on management and implementation of post-war bomb and mine consequence remediation activities who are not subject to the provisions of Clauses 1, 2 and 3, Article 12 of the Law on Health Insurance participating in group health insurance are supported by the state budget at the contribution level prescribed in Clause 4, Article 12 of the Law on Health Insurance.

5- Relatives of people working in other key organizations as prescribed by the law on key organizations who are not eligible to participate in health insurance as prescribed in points a, b, c, d, dd, e, g, h and i, Clause 1, Clause 2 and Clause 3, Article 12 of the Law on Health Insurance participate in group health insurance paid by the employer or paid by the employee or jointly paid as prescribed in Clause 1, Article 12 of the Law on Health Insurance.

6- People participating in resistance wars, defending the Fatherland, performing international duties and other subjects who have had their health insurance paid by the state budget according to the provisions of legal documents issued before January 1, 2025 participate in group health insurance paid by the state budget as prescribed in Clause 3, Article 12 of the Law on Health Insurance.

7- Military training students of the Military Command at the commune level with college or university degrees in the basic military system according to the Prime Minister's decision and legal regulations before January 1, 2025, who are receiving living expenses from the state budget and have not participated in health insurance, shall participate in group health insurance paid by the state budget as prescribed in Clause 3, Article 12 of the Law on Health Insurance.

8- The subjects specified in Clauses 1, 2, 3, 4, 5, 6 and 7 of this Article who simultaneously belong to many different health insurance participants according to the groups of subjects specified in Article 12 of the Law on Health Insurance shall participate in health insurance according to the principles specified in Point a, Clause 5, Article 13 of the Law on Health Insurance.

9- People who are subject to the provisions of Clause 4 of this Article and also subject to the provisions of Clause 4, Article 12 of the Law on Health Insurance shall be selected to participate according to the subject with the highest level of support.

Health insurance premium

The contribution level paid by the employer or paid by the employee or jointly paid by the employer is prescribed as follows:

a) The monthly contribution level of the subjects specified in Points a, c, d and e, Clause 1, Article 12 of the Law on Health Insurance is equal to 4.5% of the monthly salary used as the basis for compulsory social insurance contribution, of which the employer contributes two-thirds and the employee contributes one-third;

b) The monthly contribution level of the subjects specified in Points b and d, Clause 1, Article 12 of the Law on Health Insurance is equal to 4.5% of the monthly salary used as the basis for compulsory social insurance payment and is paid by the subject;

c) The monthly contribution level of the subjects specified in Point g, Clause 1, Article 12 of the Law on Health Insurance is equal to 4.5% of the basic salary, of which the employer pays two-thirds and the employee pays one-third;

d) The monthly contribution level of the subjects specified in Point h, Clause 1, Article 12 of the Law on Health Insurance is equal to 4.5% of the monthly salary used as the basis for compulsory social insurance contribution, of which the employer contributes two-thirds and the employee contributes one-third;

d) The monthly contribution level of the subjects specified in Point i, Clause 1, Article 12 of the Law on Health Insurance is equal to 4.5% of the basic salary and is paid by the employers of defense workers and civil servants serving in the army, and employers of police workers working in the people's police;

e) The monthly contribution level of subject 5 above is equal to 4.5% of the basic salary and is paid by the employer of the employee working in other positions in the key organization according to the provisions of the law on key;

g) Employees who are cadres, civil servants, or public employees who are being detained, imprisoned, temporarily suspended from work, or temporarily suspended from their positions without being disciplined shall have a monthly contribution equal to 4.5% of 50% of the monthly salary used as the basis for compulsory social insurance contributions of the employee in the month immediately preceding the detention, imprisonment, or temporary suspension as prescribed by law, in which the employer shall pay two-thirds and the employee shall pay one-third. In case the competent authority concludes that there is no violation of the law, the employer and the employee shall pay health insurance on the amount of salary paid in arrears.

The contribution level paid by the social insurance agency is specified as follows:

a) The monthly contribution level of the subjects specified in Point a, Clause 2, Article 12 of the Law on Health Insurance is equal to 4.5% of pension or disability allowance;

b) The monthly contribution level of the subjects specified in Points b and c, Clause 2, Article 12 of the Law on Health Insurance and Clause 1, Article 5 of this Decree is equal to 4.5% of the basic salary;

c) The monthly contribution level of the subjects specified in Point d, Clause 2, Article 12 of the Law on Health Insurance is equal to 4.5% of unemployment benefits.

The contribution level of the group paid by the state budget is prescribed as follows:

a) The monthly contribution level of the subjects specified in points e, g, h, i, k, l, m, o, p, q, r, s, t and u, Clause 3, Article 12 of the Law on Health Insurance and Clauses 2, 3, 6 and 7, Article 5 of this Decree is equal to 4.5% of the basic salary;

b) The monthly contribution level of the subjects specified in Point n, Clause 3, Article 12 of the Law on Health Insurance is equal to 4.5% of the basic salary and paid through the scholarship-granting agency, organization or unit.

The contribution level of the group supported by the state budget is prescribed as follows:

The monthly contribution level of the subjects specified in Clause 4, Article 12 of the Law on Health Insurance and Clause 4, Article 5 of this Decree is equal to 4.5% of the basic salary, paid by the subjects themselves and partially supported by the state budget according to regulations.

The monthly contribution level of the subjects specified in Clause 5, Article 12 of the Law on Health Insurance is stipulated as follows:

The monthly contribution is equal to 4.5% of the basic salary and is paid by the household or by the individual;

Household members specified in Point a, Clause 5, Article 12 of the Law on Health Insurance who participate in health insurance under the form of a household in the fiscal year shall have their contributions reduced as follows: the first person shall pay 4.5% of the basic salary; the second, third, and fourth persons shall pay 70%, 60%, and 50% of the first person's contribution, respectively; from the fifth person onwards, the contribution shall be 40% of the first person's contribution.

Level of support from the state budget

In addition, the Decree also clearly stipulates the level of support from the state budget as follows:

Support 100% of health insurance premiums for people in near-poor households residing in poor communes according to the Prime Minister's Decision and other documents of competent authorities;

Support at least 70% of health insurance premiums for subjects specified in Point a, Clause 4, Article 12 of the Law on Health Insurance;

Support at least 70% of the health insurance premium for subjects specified in Point g, Clause 4, Article 12 of the Law on Health Insurance. The support period is 36 months from the time the commune where the subject is living is no longer in an area with difficult or extremely difficult socio-economic conditions;

Support at least 50% of the health insurance premium for subjects specified in Point i, Clause 4, Article 12 of the Law on Health Insurance. The support period is 01 year from the date the subject is confirmed by a competent authority as a victim according to the provisions of the Law on Prevention and Combat of Human Trafficking;

Support at least 50% of health insurance premiums for subjects specified in points b, c, d, e and h, Clause 4, Article 12 of the Law on Health Insurance;

Support at least 30% of health insurance premiums for subjects specified in Point d, Clause 4, Article 12 of the Law on Health Insurance and Clause 4, Article 5 of this Decree.

Phuong Nhi

Source: https://baochinhphu.vn/quy-dinh-moi-ve-doi-tuong-muc-dong-bao-hiem-y-te-102250711120524105.htm