WEBVTT 00:00:07.716 --> 00:00:11.316 Hello to the audience, please watch the legal advice program of Lao Dong newspaper. 00:00:11.676 --> 00:00:15.306 Ladies and gentlemen, from July 1, 2026, many new regulations on health 00:00:15.306 --> 00:00:16.516 insurance officially take effect. 00:00:16.516 --> 00:00:19.118 bringing no small changes in contribution levels as well as medical 00:00:19.118 --> 00:00:20.536 examination and treatment benefits for participants. 00:00:21.096 --> 00:00:23.673 Notably, the expansion of benefits when outpatient medical examination and 00:00:23.673 --> 00:00:25.476 treatment, and adjustment of health insurance contributions 00:00:25.476 --> 00:00:28.276 according to the new base salary level, it also received a lot of attention from readers. 00:00:28.396 --> 00:00:31.376 Yes, to help you better understand the new regulations on health insurance, 00:00:31.376 --> 00:00:35.316 We had a conversation with Ms. Vu Thi Trang, Deputy Director of Han Yumi Law Company. 00:00:36.136 --> 00:00:37.996 Yes, hello to the audience of Lao Dong newspaper. 00:00:38.676 --> 00:00:42.321 Yes, from you, from July 1, 2026, many new regulations on health 00:00:42.321 --> 00:00:43.536 insurance officially take effect. 00:00:43.896 --> 00:00:47.020 So can you inform us what are the most important changes that people... 00:00:47.020 --> 00:00:54.218 From July 1, 2026, health insurance policies have had many changes towards 00:00:54.218 --> 00:00:56.623 expanding benefits for participants. 00:00:56.623 --> 00:01:00.382 and also at the same time adjusted some contribution levels to suit the increase 00:01:00.382 --> 00:01:03.603 of the base salary to 2 million 530 thousand VND per month. 00:01:04.203 --> 00:01:06.383 And some notable changes can be seen as follows. 00:01:06.903 --> 00:01:09.389 The first is the expansion of health insurance medical examination and 00:01:09.389 --> 00:01:11.423 treatment benefits. This is the most notable new point. 00:01:11.423 --> 00:01:14.495 According to new regulations, in many cases, health insurance participants 00:01:14.495 --> 00:01:17.260 voluntarily go for outpatient examinations at basic or specialized 00:01:17.260 --> 00:01:19.103 level medical examination and treatment facilities. 00:01:19.103 --> 00:01:21.615 without a transfer paper, the medical examination and treatment facility will 00:01:21.615 --> 00:01:24.583 still be paid by the Health Insurance Fund according to the benefit level. 00:01:24.583 --> 00:01:28.573 if meeting all the conditions specified in Circular No. 01-2025 of 00:01:28.573 --> 00:01:30.023 the Ministry of Health. 00:01:30.443 --> 00:01:33.910 This regulation creates more favorable conditions for patients to access 00:01:33.910 --> 00:01:35.643 medical facilities with appropriate expertise. 00:01:35.863 --> 00:01:38.738 A second noteworthy point is the adjustment of health insurance 00:01:38.738 --> 00:01:40.463 contributions for some groups of subjects. 00:01:41.423 --> 00:01:47.221 The base increases from 2.34 million VND to 2.53 million VND per month from 00:01:47.221 --> 00:01:48.463 July 1, 2026 00:01:48.463 --> 00:01:52.503 so the health insurance premiums of the groups are calculated according to the base salary 00:01:52.503 --> 00:01:56.843 such as households, students and some other groups will also change. 00:01:57.223 --> 00:02:00.582 A third point is to increase the level of medical examination and treatment 00:02:00.582 --> 00:02:03.423 costs paid 100% by the Health Insurance Fund for some cases. 00:02:03.463 --> 00:02:06.037 According to the provisions of the health insurance law, some benefits are 00:02:06.037 --> 00:02:07.323 determined according to the base salary. 00:02:07.323 --> 00:02:10.891 and when the base salary increases, the level of payment for the rights 00:02:10.891 --> 00:02:12.263 of participants will also increase. 00:02:13.263 --> 00:02:16.143 Fourth, it is to increase the health insurance level for people participating 00:02:16.143 --> 00:02:17.823 in health insurance for 5 consecutive years. 00:02:18.263 --> 00:02:22.203 This is a policy that benefits those who maintain health insurance for a long time. 00:02:22.603 --> 00:02:25.143 Accordingly, when meeting sufficient conditions according to the provisions of law 00:02:25.143 --> 00:02:28.450 then participants will be paid 100% of the medical examination and treatment 00:02:28.450 --> 00:02:30.103 costs by the Health Insurance Fund. 00:02:30.103 --> 00:02:33.013 when the amount of co-payment for medical examination and treatment costs 00:02:33.013 --> 00:02:35.923 in the year is more than 6 times the base salary. 00:02:35.923 --> 00:02:40.403 Due to the base salary increase from 2.34 million VND to 2.53 million VND 00:02:40.403 --> 00:02:43.723 so the health insurance level for this case will also increase. 00:02:45.000 --> 00:02:47.700 Many people are also concerned about medical examination and treatment outside the tuyến. 00:02:48.160 --> 00:02:52.940 So from July 2026, how will the rights of people going for outpatient check-ups change? 00:02:53.998 --> 00:02:56.768 Cases of self-examination for outpatient visits at provincial or central 00:02:56.768 --> 00:03:00.923 hospitals will not be reimbursed by the Health Insurance Fund if they are not on 00:03:00.923 --> 00:03:03.138 the list of diseases transferred to higher levels. 00:03:03.618 --> 00:03:09.436 However, based on Article 19 of Decree No. 188 of 2025, from July 1, 2026, 00:03:09.436 --> 00:03:12.927 health insurance participants will self-go for outpatient examinations at 00:03:12.927 --> 00:03:16.418 many basic and specialized medical examination and treatment facilities. 00:03:16.418 --> 00:03:21.053 will be paid by the Health Insurance Fund from 50% to 100% of the benefit 00:03:21.053 --> 00:03:24.142 level depending on each case, thereby significantly expanding the benefits 00:03:24.142 --> 00:03:25.378 for health insurance participants. 00:03:26.002 --> 00:03:31.102 So, is it true that from July 2006, for out-of-zone examinations, health insurance is paid? 00:03:31.842 --> 00:03:34.722 Yes, this is a point that people also easily misunderstand. 00:03:35.122 --> 00:03:37.375 The level of health insurance benefits when performing out-of-zone examinations 00:03:37.375 --> 00:03:39.402 must still fully meet the conditions according to regulations. 00:03:39.402 --> 00:03:42.637 on the type of medical examination and treatment facility, technical expertise 00:03:42.637 --> 00:03:44.402 level and scope of detailed regulations 00:03:44.402 --> 00:03:47.862 in Article 19 of Decree No. 188 of 2025. 00:03:48.682 --> 00:03:50.890 Therefore, not all cases of self-examination against the prescribed 00:03:50.890 --> 00:03:52.362 route are entitled to equal benefits. 00:03:52.362 --> 00:03:54.727 but people need to correctly identify the medical examination and treatment 00:03:54.727 --> 00:03:56.662 facility and their benefit level before going for examination. 00:03:58.005 --> 00:04:00.930 Another new thing that many people are interested in is the increase in 00:04:00.930 --> 00:04:02.505 household health insurance contributions from July 2006. 00:04:02.505 --> 00:04:04.645 Why is there this adjustment, Madam? 00:04:05.628 --> 00:04:09.690 Yes, one thing we need to understand is that from the 1st season of July 2026, 00:04:09.690 --> 00:04:12.228 the health insurance contribution rate for households will not change. 00:04:12.648 --> 00:04:15.394 The level of household health insurance contribution is still equal to 4.5% of 00:04:15.394 --> 00:04:17.928 the base salary according to the provisions of the health insurance law. 00:04:18.508 --> 00:04:22.002 The reason for this increase in contributions is that the base salary 00:04:22.002 --> 00:04:26.368 has been adjusted from 2.34 million VND per month to 2.53 million VND per month. 00:04:27.108 --> 00:04:30.168 Therefore, this is the reason why the family's health insurance premium increases. 00:04:31.112 --> 00:04:34.250 So specifically, how much money will household health insurance participants 00:04:34.250 --> 00:04:36.132 have to pay from July 2026? 00:04:37.003 --> 00:04:40.479 From July 2026, people participating in health insurance in the form of 00:04:40.479 --> 00:04:44.243 households in the financial year will implement the following health insurance contribution level. 00:04:44.383 --> 00:04:50.392 The first person in the household pays 4.5% of the base salary, equivalent to 00:04:50.392 --> 00:04:54.683 113,850 VND per month, which is 1,366,200 VND per year. 00:04:55.383 --> 00:05:00.083 The second person contributes 70% of the first person's contribution, equivalent 00:05:00.083 --> 00:05:04.783 to 79,695,000 VND per month, which is 956,340 VND per year. 00:05:04.783 --> 00:05:09.473 The third person contributes 60% of the first person's contribution, equivalent 00:05:09.473 --> 00:05:14.163 to 68,310 VND per month, which is 819,720 VND per year. 00:05:14.943 --> 00:05:19.798 The fourth person pays 50% of the first person's contribution, equivalent to 00:05:19.798 --> 00:05:23.843 56,925 VND per month, which is 683,100 VND per year. 00:05:24.083 --> 00:05:29.387 And from the fifth person onwards, only pay 40% of the first person's 00:05:29.387 --> 00:05:34.283 contribution, equivalent to 45,540 VND per month, i.e., 546,480 VND per year. 00:05:34.783 --> 00:05:35.983 Not just households, 00:05:43.998 --> 00:05:47.037 Yes, the health insurance contribution level of students is also determined 00:05:47.037 --> 00:05:48.418 according to the base salary. 00:05:48.418 --> 00:05:53.618 And so from July 1, 2026, due to the increase in the base salary 00:05:53.618 --> 00:05:56.838 So the health insurance contribution level of students will also increase accordingly. 00:05:56.838 --> 00:06:00.398 According to the provisions of Decree No. 188 of 2025 00:06:00.398 --> 00:06:03.684 The State still maintains a minimum support policy of 50% 00:06:03.684 --> 00:06:04.998 of the contribution level. 00:06:04.998 --> 00:06:09.658 So the actual amount of health insurance contributions of students is still quite low. 00:06:09.658 --> 00:06:12.458 Compared to having to pay full health insurance premiums 00:06:12.458 --> 00:06:27.938 Thank you for following and see you again 00:06:27.938 --> 00:06:17.107 A very positively assessed change is raising the threshold to be paid 100% 00:06:17.107 --> 00:06:18.518 by the Health Insurance Fund. 00:06:18.518 --> 00:06:20.818 for cases where medical examination and treatment costs are low. 00:06:21.318 --> 00:06:22.758 How is this regulation understood, Madam? 00:06:23.879 --> 00:06:26.812 According to the provisions of the 2008 health insurance law and the law 00:06:26.812 --> 00:06:29.519 amending and supplementing a number of articles of the health insurance law, 00:06:30.019 --> 00:06:32.755 then the level of medical examination and treatment costs entitled to 100% 00:06:32.755 --> 00:06:35.719 health insurance in some cases will be calculated according to the base salary. 00:06:36.179 --> 00:06:39.059 When the base salary increases to 2.53 million VND per month, 00:06:39.479 --> 00:06:41.990 then this threshold also increases correspondingly, helping many patients 00:06:41.990 --> 00:06:45.059 not have to pay together for low-cost medical examinations and treatments. 00:06:45.832 --> 00:06:48.972 For people who participate in health insurance for 5 consecutive years, the benefits may 00:06:49.007 --> 00:06:50.567 Expected from July or not, friend? 00:06:51.078 --> 00:06:54.388 Based on the provisions of Clause 1, Article 22 of the amended and 00:06:54.388 --> 00:06:56.934 supplemented health insurance clause in 2024, health insurance participants who 00:06:56.934 --> 00:06:59.734 have participated in health insurance for 5 consecutive years are still 00:06:59.734 --> 00:07:03.298 entitled to the co-payment exemption mechanism when they meet the conditions according to regulations. 00:07:03.878 --> 00:07:07.535 The cost threshold to determine this benefit is calculated according to the 00:07:07.535 --> 00:07:11.800 base salary, so from July 1, 2026, when the base salary increases, the threshold 00:07:11.800 --> 00:07:14.238 applied for co-payment exemption will also increase correspondingly. 00:07:15.509 --> 00:07:18.097 In reality, many people still do not clearly understand what it is to 00:07:18.097 --> 00:07:19.689 participate in health insurance for 5 consecutive years. 00:07:20.109 --> 00:07:23.069 Can you explain it more clearly to readers? 00:07:23.795 --> 00:07:28.630 Yes, based on the provisions of point A, section 1 of road 18, Decree No. 188 of 00:07:28.630 --> 00:07:32.043 2025 of the Government, participating in health insurance for 5 consecutive years 00:07:32.043 --> 00:07:35.741 means that a person has participated in health insurance for 5 consecutive years 00:07:35.741 --> 00:07:39.155 or more and has not been interrupted for more than 90 days. 00:07:39.495 --> 00:07:42.954 If this condition is met and the co-payment amount in the year exceeds 00:07:42.954 --> 00:07:46.413 the prescribed level, the patient will be paid 100% of the medical examination 00:07:46.413 --> 00:07:49.606 and treatment costs within the scope of benefits for subsequent examinations in 00:07:49.606 --> 00:07:51.735 the fiscal year by the Health Insurance Fund. 00:07:51.735 --> 00:07:56.255 This is a policy to encourage people to maintain long-term and uninterrupted health insurance participation. 00:07:57.105 --> 00:08:01.092 Yes, finally, what advice do you have for people to ensure their health 00:08:01.092 --> 00:08:03.545 insurance benefits after the new regulations take effect? 00:08:04.457 --> 00:08:07.099 Yes, to ensure their rights when participating in health insurance, 00:08:07.099 --> 00:08:09.477 people should pay attention to some issues as follows. 00:08:10.097 --> 00:08:14.137 The first is to maintain continuous health insurance contributions so as not to interrupt benefits. 00:08:14.657 --> 00:08:17.126 The second is to update the initial registration place for medical 00:08:17.126 --> 00:08:18.697 examination and treatment if there are changes. 00:08:19.277 --> 00:08:22.240 Third, it is necessary to carefully study the regulations on referrals, 00:08:22.240 --> 00:08:23.857 outpatient examinations and new benefit levels. 00:08:23.857 --> 00:08:27.658 Fourth, bring all medical documents when examining and proactively look up 00:08:27.658 --> 00:08:32.497 benefits on the VSSID application or the Public Service Portal of Vietnam Social Security. 00:08:33.846 --> 00:08:36.466 Yes, thank you for the sharing just now from Ms. Vu Ky Trang. 00:08:37.426 --> 00:08:40.326 Ladies and gentlemen, it can be seen from July 1, 2026, 00:08:40.726 --> 00:08:42.546 health insurance policies have many important changes, 00:08:42.706 --> 00:08:44.926 not only adjusting contributions according to the new base salary level, 00:08:45.266 --> 00:08:47.886 but also expands the benefits of medical examination and treatment for participants. 00:08:48.286 --> 00:08:51.106 Mastering all the new regulations will help everyone be more proactive. 00:08:51.106 --> 00:08:54.746 in participating in using health insurance cards and ensuring their rights. 00:08:55.166 --> 00:08:58.006 The content just now has also closed today's legal advice program. 00:08:58.006 --> 00:08:59.646 Greetings to you and see you again!