The Law amending and supplementing a number of articles of the Law on Health Insurance No. 51/2024/QH15 ( Law on Health Insurance 2024), passed by the National Assembly on November 27, 2024, is an important step forward in expanding access to health services and ensuring fairness in health care.
The law pays special attention to groups such as the poor, people living in disadvantaged areas, people with meritorious services to the revolution. One of the highlights of the Law is that specifying the groups of subjects entitled to 100% of the cost of medical examination and treatment of health insurance, clearly showing the humanity and sustainable social security orientation of the State in the new period.
From July 1, 2025, many groups of people will receive 100% of health insurance examination and treatment costs, expanding benefits for people, especially those in need and those with revolutionary contributions.
The subjects specified in Points a, b, c, d, dd, e, h, i, o, r and s, Clause 3, Article 12 of the Law on Health Insurance 2024 will be entitled to all costs for health insurance examination and treatment, including:
- Armed forces and those who enjoy the regime of soldiers: Officers, non-commissioned officers, professional soldiers currently in active service in the army and officers, non-commissioned officers and technical officers of the People's Public Security; those working in secret services receive salary like soldiers.
- Students of the armed forces include: non -commissioned officers and soldiers of the People's Army in the army; non -commissioned officers and soldiers in the People's Police; Military students, police students, cipher students enjoy living expenses are Vietnamese; Military students, police students, cipher students enjoy living expenses are foreigners; Students trained reserve officers for 03 months or more not participating in social insurance and health insurance.
- Standing militia.
- People with revolutionary contributions and veterans.
- Children under 6 years old.
- Relatives of martyrs, people with meritorious services to nurture martyrs.
- People from poor households; ethnic minorities from near-poor households residing in communes and villages in ethnic minority and mountainous areas; ethnic minorities living in areas with difficult socio-economic conditions; people residing in areas with special difficulties, island communes, and island districts.
- People receiving monthly social allowances; people receiving monthly allowances for support according to the law; people receiving monthly death allowances are eligible for social allowances.
- People aged 75 and over receive monthly death benefits, people aged 70 to under 75 in near-poor households who are receiving monthly death benefits.
In some special cases, the health insurance fund pays 100% of the costs
Pursuant to Points b, c, d, Clause 1 and Clause 5, Article 22, the Law on Health Insurance 2024, in addition to the above groups of subjects, the Law also stipulates special cases where the Health Insurance Fund will cover 100% of expenses:
- The cost of one-time medical examination and treatment is lower than the Government's regulation.
- Medical examination and treatment at the medical facility of the primary level of subordinates, including: Health Station; Family medical examination and treatment facility; Military - People's Medical Station, Military - People's Clinic; The district health center has medical examination and treatment activities that are licensed to operate in the form of an organization of the clinic; Health of agencies, units and organizations prescribed by the Minister of Health; Medical examination and treatment establishments under the initial medical examination and treatment in the army and police are prescribed by the Minister of Defense and the Minister of Public Security. 100% of the cost of outpatient medical examination and treatment at the regional clinic.
- Health insurance participants for 5 consecutive years or more and the amount of money spent on medical examination and treatment during the year is 6 times greater than the basic salary.
- Emergency medical examination and treatment at any medical facility.
5-year consecutive health insurance is when the health insurance participant has paid for 5 consecutive years, of which a maximum of 3 months is allowed.
