Holding a HI card but still “unsure what I’m covered for” — the reality for most members, Vietnamese included. Since 1/7/2025, the amended HI Law (51/2024/QH15) simplified the picture: administrative boundaries erased, 100% for critical illnesses. Know these 4 numbers and you’ll never be short-changed at hospital billing.
HI benefit rates: 4 core numbers
- 80%: the employee rate (including foreign workers in compulsory HI) for compliant care — the fund pays 80%, you co-pay 20% within coverage.
- 100%: policy groups (the poor, under-6 children, contributors…) and — new since 1/7/2025 — critical/rare diseases in the Ministry of Health’s 62-disease list go straight to specialised hospitals without referral papers, at 100% from the first visit.
- 100% at any first-registration facility: since 1/7/2025, boundaries erased — registered in Hanoi, examined at another first-registration facility in HCMC, still full in-network benefits.
- 40%: off-network inpatient care at specialised facilities (except higher-entitled cases) — still the “penalty” for unprioritised line-jumping.
Co-payment and caps: 2 little-known points
- 5 continuous years: members with 5 continuous years whose annual co-payments exceed 6 months’ base salary get 100% on compliant care — the loyalty “reward”.
- Coverage list: HI pays only within the Ministry of Health’s drug, supply and technical-service lists — off-list drugs and on-demand services (private rooms, chosen doctors) are 100% yours.
Foreigners using HI: 3 practical tips
- Use VssID/chipped CCCD instead of paper cards: show the e-card on the VssID app or chipped CCCD at admission — no paper card needed.
- Register first care where there’s an international department: major hospitals (Bach Mai, Cho Ray, Viet Duc…) run international clinics — register there for HI benefits plus English interpretation.
- Keep invoices for off-network emergencies: emergencies count as in-network — keep all invoices and discharge papers for reimbursement from the social insurance office.
FAQs
Off-network outpatient at a top hospital — what rate?
Per the Decree 188/2025 roadmap: from 1/7/2026, off-network outpatient care at certain basic/specialised facilities pays 50% of benefits. Inpatient at specialised facilities that were provincial-level before 1/1/2025: 100%.
Childbirth covered by HI?
Yes — listed delivery costs (natural/caesarean) are fund-paid at your benefit rate. On-demand extras (chosen doctor, private room) are out-of-pocket.
HI for routine health check-ups?
No — non-illness periodic check-ups aren’t HI-covered. HI pays only for disease examination and treatment.
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FLAT Law Firm advises foreign nationals and their families on inheritance, wills, driving licences, health insurance and money transfers in Vietnam. Contact us for advice on your specific case.
