WEBVTT

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From July 1, 2025, the amended health
insurance law officially takes effect, 

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brings many new benefits to health insurance participants. 

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In particular, a notable change is that
medical examination and treatment is no 

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longer limited by the administrative
boundaries of the province, operating as before. 

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According to the new regulations, health
insurance participants can examine and 

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treat patients at any basic medical facility nationwide, 

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Previously, it was identified as a
district level, regardless of 

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administrative boundaries, but still
enjoyed full benefits under the health insurance card. 

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For example, people with health
insurance cards register for initial 

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medical examination and treatment in the city, 

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Ho Chi Minh can still go to a district
hospital in Hanoi for medical 

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examination and treatment and be paid by the health insurance fund as registered. 

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Specifically, health insurance
participants are entitled to 100% health 

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insurance when receiving medical
examination at the initial registration 

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location nationwide, regardless of province or city. 

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Receive 100% health insurance when
receiving inpatient treatment at 

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basic health facilities nationwide. 

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Receive 100% health insurance when
examining at basic or specialized 

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medical facilities, if before January 1,
2025, these facilities were 

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classified as district-level facilities. 

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However, this regulation only applies to
cases of health insurance examination 

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and treatment at medical facilities previously identified as district-level. 

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For specialized facilities, to receive
health insurance when examining and 

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treating patients, patients must undergo referral procedures for expertise. 

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In case the health insurance participant
arbitrarily goes to a specialized level 

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for medical examination and treatment
without a referral letter, the health 

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insurance benefit will be paid according to the prescribed deduction level. 

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Specifically, when receiving inpatient
examination at the specialized level, 

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without transfer, only 40% of the health
insurance level is enjoyed, when 

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receiving outpatient examination at the
specialized level, 50% of health insurance is enjoyed. 

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According to the roadmap, boarding at
the specialized level used to be a 

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provincial level, before January 1,
2025, health insurance participants will 

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still receive 100% of the health
insurance if patients are hospitalized for treatment. 

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Thus, although the referral is expanded,
if patients want to receive medical 

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examination and treatment at provincial,
central, and specialized facilities, and 

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are not exempted from referral, they
still need a valid referral letter 

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to receive full health insurance.