What will change in the 5-year continuous health insurance policy from July 1, 2025?

The revised Law on Health Insurance 2024 has many changes that are more beneficial to patients. Follow the article below from Faro Vietnam to see what changes have been made to the 5-year health insurance policy since the revised Law took effect?

1. What will change in the 5-year continuous health insurance policy from July 1, 2025?

Based on Clause 17 of the 2024 amended Law on Health Insurance, the conditions for enjoying 5-year continuous health insurance are as follows:

1. When participating in health insurance, when undergoing medical examination and treatment as prescribed in Articles 26 and 27 of this Law, the health insurance fund will pay for medical examination and treatment costs within the scope of benefits at the following levels:

…

d) 100% of medical examination and treatment costs when the patient has participated in health insurance for 5 consecutive years or more and has the amount of money to co-pay for medical examination and treatment costs in the year of medical examination and treatment as prescribed in Clause 3, Points a, b, c, d and e, Clause 4, Clause 5 of this Article, Article 26 and Article 27 of this Law is 6 times greater than the reference level;
 

Patients will enjoy additional benefits from July 1, 2025

According to the above provisions, it can be seen that the amended Law stipulates the conditions for patients who have participated in health insurance for 5 consecutive years or more to enjoy 100% of medical examination and treatment costs when:

(1) The amount of co-payment for medical examination and treatment costs in the year of medical examination and treatment as prescribed below is greater than 6 times the reference level

(2) When examining and treating at a place other than the place of initial health insurance medical examination and treatment registration

(3) Going to a medical examination and treatment at a place other than the facility initially registered for medical examination and treatment under health insurance, not at the place initially registered for medical examination and treatment, not following the procedure for transferring patients between medical examination and treatment facilities under health insurance.

(4) When examining and treating at any medical examination and treatment facility in an emergency

(5) When registering for initial health insurance examination and treatment

(6) Transferring patients between health insurance examination and treatment facilities

Thus, to enjoy health insurance for 5 consecutive years from July 1, 2025, the following conditions must be met at the same time:

• Have participated in health insurance for 5 consecutive years or more;
• Have the amount of co-payment for medical examination and treatment costs in the year greater than 6 times the reference level;
• Go to the right health care facility, follow the procedure of transferring patients between health care facilities with health insurance or go to the wrong health care facility in the cases mentioned in (3) above or emergency in all cases

And people who have participated in health insurance for 5 consecutive years or more must have the amount of co-payment for medical examination and treatment costs in the year greater than 14.04 million VND (6 months of basic salary) and receive medical examination and treatment in the right health care facility to enjoy health insurance benefits for 5 consecutive years

It can be seen that the amended Law stipulates that the amount of medical examination and treatment costs in the year is greater than 6 times the level Reference (based on Clause 5, Article 3 of the Law amending and supplementing the Law on Health Insurance 2024, 06 times the reference level from July 1, 2025 is 14.04 million VND, until the Government has new regulations)

The amended Law also specifically stipulates that cases of continuous participation in health insurance for 5 years are entitled to 100% health insurance (including cases of non-network coverage).
 

According to the revised Law on Health Insurance 2025: Health Insurance Policy

2.  Groups of subjects participating in health insurance from July 1, 2025

Specifically, the amended Law on Health Insurance 2024 has amended Article 12 of the Law on Health Insurance 2008 to stipulate the subjects participating in health insurance as follows:

(1) Groups paid by employers or employees or jointly paid (currently the group paid by employees and employers);

(2) Groups paid by social insurance agencies (currently the social insurance organizations);

(3) Groups paid by the State budget;

(4) Groups supported by the State budget;

(5) Groups paying health insurance themselves (currently, the group participating in health insurance by household);

(6) Subjects other than those specified in (1), (2), (3), (4), (5).

>>>Read more: Talent Acquisition Solutions for 2025

The above is information about the 5-year continuous health insurance policy, what has changed since July 1, 2025. If you need more assistance, please contact us:

Faro Vietnam

• Email: service@farovietnam.com.vn

HANOI HEAD OFFICE

• Tel: + 84 24 3974 3091

HO CHI MINH CITY OFFICE

• Tel: + 84 28 3821 4654

Grow your business with our trusted Human Resource Solutions.