Vietnam’s healthcare landscape is undergoing meaningful changes with the amendment and supplementation of the Health Insurance Act. These revisions aim to bolster social security, enhance healthcare accessibility, and ensure the long-term sustainability of the health insurance system. A key aspect of the updated law involves expanding the rights and benefits available to health insurance participants.

The new legislation introduces a “reference level” to replace the previous “minimum wage” standard for calculating services and contributions. this adjustment is designed to provide a more flexible and responsive framework that aligns with current socio-economic conditions.

Article 11,Clause 11 of the amended law outlines a revised structure for family health insurance contributions.The first insured member pays a maximum of 6% of the reference amount.Subsequent members receive discounted rates: 70% for the second, 60% for the third, and 50% for the fourth. From the fifth member onward, the contribution is capped at 40% of the first member’s contribution. The government sets the reference amount, which is the basis for calculating contributions and services for specific health insurance cases; in 2025, the basic salary reference is 2,340,000 VND per month.

These adjustments lead to increased family health insurance costs. Prior to July 1, the annual health insurance contribution for the first person was 1,263,600 VND, but it has since risen to 1,684,800 VND. Similarly, the second person’s contribution increased from 758,160 VND to 1,010,800 VND per year, and the third person’s contribution rose from 631,800 VND to 842,400 VND per year.

The increase in health insurance contributions has raised concerns among citizens and employees, especially given the rising cost of living. Some worry about the financial strain on families.

Mr. Phan Trong Hieu, a 41-year-old resident of the GO VAP district, shared that his family of five, including three young children, struggles to manage expenses on their combined factory wages of 15 million VND per month. The increased health insurance costs add to their financial worries.

mr. Nguyen trong Toan, a 32-year-old from the Binh Thanh district, expressed concern that increased premiums without a corresponding improvement in the quality of medical examinations and treatments would disadvantage the public.

Streamlining Support and Guidelines

“Solutions are required to improve resource efficiency and the surveillance function of the health insurance…Duong Duc Tuan.”

According to duc Duc Tuan, Head of the Health Insurance Policy Department (Vietnam social Security), approximately 95.52 million people are currently insured nationwide, representing a coverage rate of 94.2% of the population. By the end of May 2025, vietnam Social Security covered medical examination and treatment costs for nearly 80 million people, totaling over 63,300 billion VND – a 15.59% increase compared to the same period last year. However, the sustainability of this coverage is in question, as roughly 50% of health insurance is financed, either wholly or partially, by the state budget.

the current payment mechanism, based on service fees, may incentivize unnecessary or more expensive services. Furthermore, the concentration of medical facilities in central, crowded areas limits access for those in rural, remote, and isolated regions.

Duong Duc Tuan emphasized the need for solutions to improve resource efficiency and enhance health insurance oversight, such as the early adoption of controlled payment methods and ensuring that patient services meet quality standards.

Regarding the expansion of services covered by health insurance, particularly home-based and remote medical examinations and treatments, leaders of lower-level medical facilities believe that cost coverage for at-home care would benefit both patients and facilities.

However, challenges remain, as payments are contingent on operating licenses and named physicians. The Ministry of Health is tasked with providing guidance on selecting disease groups and examination types for cost coverage of home visits to prevent abuse and overspending. Simultaneously, the quality of medical services must be improved to better serve patient needs.

According to Tran Thi trang, director of the Health Insurance Department (Ministry of Health), increasing health insurance premiums for families, especially those with low or medium incomes, could jeopardize their ability to maintain coverage. She suggested that the state should implement support measures for low-income families,particularly those with many children or individuals with serious illnesses.