Previously, people with health insurance cards (HI) when undergoing outpatient treatment outside the tuyến at central-level hospitals were often not paid by the HI Fund. However, from July 1, 2026, the new policy will allow patients to be paid 50% of the HI benefit level when undergoing outpatient treatment outside the tuyến at some central-level hospitals ranked as basic level.
According to regulations, health insurance participants currently enjoy a payment level of 80%, 95% or 100% of medical examination and treatment costs, depending on each group of subjects. When performing outpatient examinations outside the line at hospitals subject to application, the amount paid by the Health Insurance Fund is calculated according to the formula:
Medical examination and treatment costs × Health insurance benefit level × 50%
For example, if a person has a health insurance benefit level of 80%, if they have an outpatient examination outside the line at a central-level basic hospital with a total cost of 1 million VND, the health insurance fund will pay 400,000 VND (1,000,000 × 80% × 50%), and the patient will pay 600,000 VND on their own.
The list of hospitals subject to this policy includes many medical facilities nationwide.
In Hanoi, there is Huu Nghi Hospital and the Central Forensic Psychiatric Institute.
In Dong Nai, there is the Central Mental Hospital II and the Bien Hoa Central Psychiatric Forensic Institute.
Thanh Hoa has Central Hospital 71 and Central Rehabilitation Nursing Hospital.
In addition, the policy is also applied to many other hospitals such as Hue Central Hospital Branch 2, Vietnam - Cuba Dong Hoi Friendship Hospital, Quy Hoa National Leprosy and Dermatology Hospital, National Hospital 74, Quynh Lap National Leprosy and Dermatology Hospital, Institute of Marine Medicine, and Quang Nam National General Hospital.
Many practice hospitals of medical and pharmaceutical universities under the Ministry of Health are also ranked as basic, including Hai Duong Medical Technical University Hospital, Thai Binh Medical University Hospital, Hai Phong Medical University Hospital, Can Tho University Medical and Pharmaceutical Hospital and Tue Tinh Hospital.
For the Ministry of Public Security, four hospitals are ranked at the basic level, including Hospital 19-8 (Hanoi), Hospital 30-4 (HCMC), Hospital 199 (Da Nang) and Traditional Medicine Hospital (Hanoi).
The new policy is expected to help health insurance participants reduce the burden of costs when outpatient examination and treatment outside the line at central-level hospitals subject to application, and at the same time create more favorable conditions for accessing high-quality medical services.
