From 2026, health insurance (HI) policy will continue to have many notable points, including clearly stipulating groups of subjects who are paid 100% of medical examination and treatment costs by the HI Fund. At the same time, the cost for each examination below a certain threshold will also be fully paid, helping to significantly reduce the financial burden for people.
11 groups are covered 100% by health insurance
According to the 2008 Health Insurance Law (amended and supplemented), there are currently 11 groups of subjects who are 100% reimbursed by the Health Insurance Fund for medical examination and treatment costs, including:
Officers, professional soldiers; police forces and people working in cipher work who receive salaries like soldiers.
Non-commissioned officers, in-service soldiers; military, police, and cipher trainees who receive living expenses are Vietnamese people.
Military, police, and cipher students who enjoy living expenses are foreigners.
Trainees who train as reserve officers for 3 months or more have not participated in social insurance or health insurance.
Standing militia.
People with meritorious services to the revolution; veterans.
Children under 6 years old.
Relatives of martyrs, people who nurtured martyrs.
People from poor households; some ethnic minority groups, people living in difficult and extremely difficult areas, island communes, and island districts.
People who are receiving monthly social allowances, nursing allowances or survivorship allowances are subject to social protection.
People aged 75 and over are entitled to monthly survivor's allowance; people aged 70 to under 75 from near-poor households are currently receiving survivor's allowance.
These are vulnerable groups, or those with special contributions to society, who are prioritized by the State to ensure health care rights.
100% reimbursed cost milestone from July 1. 2026
Besides the group of subjects, the new regulation also clarifies cases where patients are still fully reimbursed by health insurance even if they do not belong to the above groups.
According to Decree 188/2025/ND-CP, if the cost for one medical examination and treatment is less than 15% of the base salary, the HI Fund will pay 100%, and patients do not have to pay more.
Currently, the base salary currently applied is 2.34 million VND/month. Accordingly, the corresponding cost to be fully paid is under 351,000 VND/examination.
However, according to information at a meeting with voters in March 2026, it is expected that from July 1, 2026, the base salary may be adjusted to increase by about 8%, to about 2,527,200 VND/month.
If this option is applied, the level of medical examination and treatment costs to be 100% reimbursed by health insurance will also increase to about 37,980 VND/time.
Adjusting the payment threshold according to the base salary helps health insurance policies to be more flexible in the face of economic fluctuations. At the same time, this regulation is especially meaningful for cases of regular medical examination and treatment, low costs.
In the context of increasing medical costs, expanding the 100% coverage range not only supports people, but also contributes to encouraging early medical examination, reducing the risk of serious illness and overload for the health system.
