Vietnam Social Security has just provided specific information on the health insurance (HI) benefits for students under the 2024 Health Insurance Law.
Procedures for medical examination and treatment under health insurance
When receiving health insurance treatment, students must present one of the following documents:
valid health insurance card or Health insurance card image on the VssID application - Digital Social Insurance and photo identification documents.
ID card or chip-embedded citizen ID card or level 2 electronic identification account (VneID) with integrated information about the health insurance card.
Level of health insurance for students
Medical facilities have signed health insurance medical examination and treatment contracts
First, in the case of health insurance medical examination and treatment in accordance with regulations: Right place of initial registration on the card or transfer to medical examination and treatment level in accordance with regulations and complete all procedures.
Second, the case of health insurance medical examination and treatment is not in accordance with regulations: self-treatment of medical examination and treatment is not in accordance with the original medical examination and treatment registration facility; transferring patients between health insurance medical examination and treatment facilities is not in accordance with regulations.
Third, in case a patient with a health insurance card shows up for medical examination and treatment late and presents card information, the health insurance fund will pay for medical examination and treatment within the scope of benefits and benefits from the time of presentation of health insurance card information, except in emergency cases.
The cost of medical examination and treatment during the period when the patient has not presented health insurance card information will be paid directly by the health insurance fund according to regulations.
Medical facilities do not have health insurance medical examination and treatment contracts
The Social Insurance agency will directly pay the cost of health insurance medical examination and treatment for the following cases:
Basic medical examination and treatment facilities (under 50 points as prescribed) or before January 1, 2025, have been identified by competent authorities as district-level facilities or are temporarily classified as basic facilities:
Outpatient medical examination and treatment, receive a maximum of 0.15 times the basic salary at the time of medical examination and treatment (2,340,000 VND x 0.15 = 351,000 VND).
Boarding medical examination and treatment, are entitled to a maximum of 0.5 times the basic salary at the time of discharge (2,340,000 VND x 0.5 = 1,170,000 VND).
Basic-level medical examination and treatment facilities (from 50 points to less than 70 points according to regulations) or before January 1, 2025, have been identified by competent authorities as provincial level:
Boarding medical examination and treatment, receives the maximum of 1 time of basic salary at the time of discharge from the hospital (2,340,000 VND).
In-depth medical examination and treatment facilities:
Boarding medical examination and treatment, receive a maximum of 2.5 times the basic salary at the time of discharge (2,340,000 VND x 2.5 = 5,850,000 VND).
Social Insurance agencies directly pay for other special cases within the scope of benefits of health insurance participants
- In case the health insurance card data is not provided or the health insurance card information is not provided accurately.
- In case the patient cannot present a health insurance card before the end of the treatment period, transferred to the hospital on the same day due to emergency situation, loss of consciousness or death or loss of card but has not been reissued.
In these cases, patients need to contact the social insurance agency for specific instructions on direct payment procedures.
Emergency cases
Receive medical examination and treatment at any medical examination and treatment facility and must present information about the health insurance card, identification documents with photos before the end of the treatment period to enjoy full health insurance benefits.
Vietnam Social Security also noted a number of new regulations on health insurance treatment for health insurance participants (including HSSV) in Decree No. 188/2025/ND-CP dated July 1, 2025 of the Government detailing and guiding the implementation of a number of articles of the Health Insurance Law, specifically as follows:
In case of late presentation of the card: enjoy health insurance benefits from the time of presentation of the health insurance card.
In case when receiving medical examination and treatment, the card is still valid but when receiving inpatient treatment, outpatient treatment, or daytime treatment at the medical examination and treatment facility, the health insurance card expires, the health insurance fund will pay the medical examination and treatment fee for no more than 15 days from the date the health insurance card expires; at the same time, when discharged from the hospital, at the end of the medical examination and treatment period, the patient is responsible for paying health insurance in continuation with the expiration of the health insurance card.
Expand cases that are paid directly: time not yet presented with health insurance cards at medical facilities; Patients in emergency, unconscious or dying without presenting health insurance card information before being discharged from the hospital.
When receiving medical examination and treatment at medical examination and treatment facilities that organize health insurance examination and treatment outside of office hours or on holidays: People with health insurance cards who come to the medical examination and treatment will be paid by the health insurance fund within the scope of benefits and health insurance benefits.
