Vietnam’s latest changes to public health insurance are now in effect, extending full coverage to more low-income and elderly citizens from Jan. 1, under a resolution adopted by the National Assembly in December 2025.
According to a report by Vietnam Plus, health insurance cardholders from near-poor households and people aged 75 or older who receive social pension benefits are now entitled to 100% reimbursement of covered medical examination and treatment costs, the Ministry of Health said. The ministry has issued an urgent notice to Vietnam Social Security (VSS), local health authorities, and medical facilities directing them to adjust benefit codes and administrative systems to reflect the new entitlements. The instructions are intended to ensure that hospitals and clinics apply the updated coverage for the newly eligible groups without gaps in application.
Previously, near-poor households were generally reimbursed for 95% of covered medical expenses under the statutory health insurance scheme. As of Jan. 1, that co-payment is removed for covered services, placing this cohort in a group eligible for full reimbursement. Health authorities have asked insurers, social security offices, and providers to report implementation issues to evaluators and social security bodies so that problems can be addressed and benefit payments continue as scheduled.
According to VSS, reimbursements follow Article 22 of the 2024 Law on Health Insurance, which specifies 11 groups entitled to full coverage of eligible medical costs. These groups include:
For insurers and health-care providers, the change may alter claims patterns, utilisation levels, and the balance between public and private health provision, particularly in segments where statutory and commercial health cover overlap.
The new entitlements come into force against a backdrop of separate government targets to achieve health insurance coverage for more than 95% of the population by 2026 and universal coverage by 2030, under a roadmap that also envisages exemption from basic hospital fees within the health insurance benefit package. According to Vietnam Plus’s report, these objectives are set out in Resolution 72-NQ/TW of the Politburo on “breakthrough measures to strengthen the protection, care, and improvement of public health,” signed by Party General Secretary To Lam. The resolution describes health insurance as a central pillar of the country’s social security system and says it has been “consistently prioritised and widely implemented” by the Party and the State.
To expand participation, authorities are combining employer–employee contributions with household-based enrolment. VSS outlines a stepped contribution schedule for household members:
Contributions can be paid quarterly, biannually, or annually via social insurance offices, collection agents, the national public service portal, the VSS mobile application, and banking channels. Enrolled individuals receive coverage for medical services within their entitlement scope, may choose or change their registered primary facility in the first 15 days of each quarter, and have access to information on their benefits. They also retain the right to file complaints or denunciations in the event of disputes or alleged violations.
In emergencies, policyholders may seek treatment at any licensed medical facility and keep their health insurance benefits. When they use their registered primary facility, up to 100% of eligible costs can be paid by the fund, particularly at the primary care level or after five consecutive years of participation. For out-of-network services, the fund covers a portion of the bill, generally between 40% and 80%, depending on the facility level and type of service.
These public-sector measures coincide with a market environment in which non-life insurance, especially health, is growing faster than life business. Estimates from the National Statistics Office indicate that Vietnam’s insurance sector generates about VNĐ237.2 trillion (US$9.1 billion) in premium income in 2025, a 4% increase from 2024. Life insurance premiums are estimated at VNĐ148.8 trillion, up 0.5% year on year, while non-life premiums are put at VNĐ88.4 trillion, rising 10.3%.
In the fourth quarter of 2025, total premium revenue is estimated to be 4.5% higher than in the same period a year earlier. Life premiums in the quarter are expected to increase by around 1.1%, compared with an 11.1% rise in non-life premiums. Data from the Insurance Association of Vietnam show that health insurance is the largest non-life segment by premium revenue in the first nine months of 2025, ahead of property, engineering, motor, marine, and other lines. In life insurance, total premiums for the first nine months of 2025 are estimated at VNĐ105.8 trillion, down 0.65% from the same period in 2024. For insurers and intermediaries in Vietnam and across Asia, the combination of expanded state health coverage, relatively faster non-life premium growth, and the scale of health business is expected to influence product design, pricing, distribution, and capital allocation, as carriers reassess how public and private coverage interact across income segments and regions.
