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Welcoming you back to the Legal
Consulting program of Lao Dong Newspaper. 

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Ladies and gentlemen, from July 1, 2025,
the 2024 Law on Health 

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Insurance takes effect. 

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Decree 188-2025-NDCP details and guides
the implementation of a number of 

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articles of the Law on Health Insurance. 

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In which, there are many new contents
related to cases that are not 

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considered evasion of health insurance payment, 

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the amount to be refunded to patients in
cases of late payment or evasion of health insurance payment. 

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To help readers better understand the
new regulations in the Law 

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on Health Insurance 2024, 

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Lao Dong Newspaper had a conversation
with lawyer Nguyen Doan, demanding a lawyer from Hanoi City. 

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I would like to greet you, the audience of the labor newspaper. 

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Lawyer, can you tell us how specifically
the cases that are not considered 

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evasion of health insurance payment are
regulated under Decree cul? 

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Yes, according to Decree No. 188, cases
considered as evasion of health 

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insurance payment are stipulated in
Point A, Point C about 1.48B of the law 

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on health insurance. 

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is not considered an insurance evasion
when there is one of the following 

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reasons according to the announcement
of the competent state agency 

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on natural disaster prevention,
emergency situations, civil defense 

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and disease prevention 

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including the first case of storms,
floods, inundation, earthquakes, major 

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fires, and prolonged droughts 

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and other natural disasters that
directly and seriously affect 

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production and business activities 

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Second is the dangerous epidemic
announced by a competent state agency 

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seriously affecting the production and
business life and financial capacity 

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of the organization 

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as well as an employer 

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Third is the emergency situation
according to the law 

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causing sudden impacts 

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surprised by the activities of
organizing agencies and employers 

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Fourth is other force majeure events as
prescribed by civil law 

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Yes, lawyer, determining the amount to
be paid and refunding expenses to patients 

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in case of late payment, how is the
specific regulation on health insurance payment? 

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Yes, for determining the amount,
according to regulations, it will be 

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determined as follows, calculated using
the CDT formula in PST x N x 0.03, in 

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which CDT is the amount to be paid on
the number of days of late payment and 

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burial for the month, PST is the amount
to be paid arising for the month, N is 

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the number of days of
late payment and burial. 

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Second, the organization that organizes
employers who are late in paying or 

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burying health insurance will refund
medical examination and treatment costs 

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according to health insurance for
employees in cases where the 

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organization that organizes employers
who are late in paying or burying health 

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insurance will do the following. 

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Especially the employee or relatives or
legal representative as prescribed by 

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law of the employee directly submits the
dossier according to the dossier 

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composition prescribed in Clauses 2, 3,
4, Article 5 of the decree. 

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Allow employers to organize late payment
and burying health insurance. 

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The employer's organization is
responsible for paying the cost of 

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medical examination and treatment for
the employee or relatives or legal 

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representative according to the
provisions of the employee's law within 

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40 days from the date of receipt of
a complete payment request. 

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The medical examination and treatment
facility will provide a cost statement 

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determining the amount of money the
patient has paid to the medical 

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examination and treatment facility,
along with legal invoices. 

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According to the patient's request to
serve as a basis for the patient to 

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propose refunding medical examination
and treatment costs according to the medical records. 

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Dear lawyers, determining the amount of
payment and payment support for some subjects 

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When the state adjusts the level of
health insurance contribution, how is 

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the basic salary adjusted? 

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For the group of subjects, it is
stipulated in about 3 articles 12 of 

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the law on health insurance 

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and subjects are supported with 100% of
the health insurance premium as 

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prescribed in Point A, about
6 of the decree 

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which is supported by the state budget
at 100% of the health insurance premium. 

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The amount of monthly state budget
support is determined according to the 

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health insurance contribution level
multiplied by the basic salary. 

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When the state adjusts the level of
health insurance contribution, adjusts the basic salary 

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the amount of state budget contributions
will be adjusted from the date of 

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application of the new health insurance
contribution level and the new basic salary level. 

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The amount of health insurance payment
for subjects specified in Point H is 

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about 3 months, Article 12 of
the law on health insurance 

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will be calculated from the date of
birth to the date the child is 

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72 months old. 

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The case of Vietnamese children born abroad 

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the amount of health insurance payment
is calculated from the time of youth 

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returning to Vietnam and residing in
accordance with the provisions of law. 

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For the group of subjects, the state
budget supports a part of the health insurance contribution level 

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is stipulated in Points B and D about 4
and 12 of the Law on Health Insurance. 

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chipees paid by participants and
support from the state budget 

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monthly is determined according to the
health insurance contribution rate 

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multiplied by the basic salary 

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at the time the
participant pays health insurance. 

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When the state adjusts the level of
health insurance contribution and adjusts the basic salary 

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participants and the state budget do not
have to pay additional 

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or do not have to return the offending painting. 

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Adjusting health insurance contribution levels and basic salary levels 

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for the remaining period of time that
the participants have paid health insurance. 

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For the group of subjects participating in health insurance 

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as prescribed in about 5 articles 12 of
the law on health insurance 

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the monthly payment amount of
the participants is determined 

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according to the health insurance
contribution rate multiplied by the basic salary 

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at the time of health insurance payment. 

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When the state adjusts the
health insurance contribution level 

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as well as adjusting the basic salary 

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participants do not have to pay
additional fees or will not be refunded. 

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The painting is skewed due to the
adjustment of health insurance contribution levels 

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basic salary for the remaining time 

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that the person has participated in paying health insurance. 

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Subjects participating on the days of the month 

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the amount of health insurance payment is determined 

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by month from the date
of health insurance payment. 

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Yes, sir, many readers are interested in
how much is the benefit level for cases 

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participating in health insurance, going
to the doctor, and receiving 

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treatment according to the requirements? 

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For this issue, people with a health
insurance card who go to the hospital 

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for examination and treatment as
required will be paid by the health 

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insurance fund for the cost of medical
examination and treatment according to 

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the scope of benefits and the level of
benefits of the law on health insurance. 

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The difference between the cost of
medical examination and treatment 

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services as required and the cost paid
by the health insurance fund paid by 

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patients to medical examination and treatment facilities. 

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Medical examination and treatment
facilities are responsible for ensuring 

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human resources, professional
conditions, publicizing expenses that 

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patients have to pay outside the scope
of benefits and health insurance 

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benefits, the cost of admission and must
notify patients in advance. 

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Yes, thank you, lawyer Nguyen Doan, for sharing this recently. 

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Dear friends, you have just listened to
lawyer Nguyen Doan 

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discuss Decree 188-2025-NDCP, 

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detailing and guiding the implementation
of a number of articles of the law on health insurance. 

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We hope that the information shared by
lawyer Nguyen Doan will help 

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you better understand this regulation. 

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We also hope to continue
to receive feedback from readers. 

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But your concerns and questions will be
the most common foot suggestions 

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so we can build content
in the next broadcasts. 

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Now, our legal consultation
should end here. 

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Thank you for your attention. 

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And now, thanks and see you again!