The Law on Health Insurance (HI) was passed by Viet Nam’s National Assembly on 14 November 2008 and took effect on 1 July 2009. On 27 July 2009 and 14 August 2009, Decree 62 and Circular 9, respectively, were issued to provide more details for implementing the Law on Health insurance.

The Law on HI provides for the coverage both of domestic and foreign individuals and organizations in Viet Nam. Decree 62 and Circular 9 clarify that effective 1 October 2009; foreign employees are subject to mandatory HI contributions in the same manner as Vietnamese employees. This is the first time that Viet Nam includes foreign employees in the scope of its national HI programme. However, foreign employees are not subject to Viet Nam’s social insurance or unemployment insurance scheme.

The HI contribution rate from 1 January to 31 December 2009 was 3 per cent. From 1 January 2010, the contribution rate is 4.5 per cent. The minimum income for contribution collection is the Vietnamese minimum salary, currently at VND 650,000 (USD 37 in 2009). The maximum income subject to HI contribution is capped at 20 times the Vietnamese minimum salary or VND 13 million (USD 743 in 2009). The employer is obligated to pay two-thirds and the employee one-third of the monthly contributions.

Under the new law, persons covered under the programme have the right to (a) be provided with a health insurance card, (b) choose their initial examination and treatment provider, (c) receive examination and treatment, (d) receive reimbursement for costs of examination and treatment from a health insurance organization, (e) request and receive information about the health insurance regime, and (f) file claims and denunciations against breaches of the law on health insurance.

The new law entitles covered persons to a wide range of benefits including inpatient care, outpatient care, functional rehabilitation, pre-natal and maternity services, transportation to hospital of referred transfers or emergency cases.

For medical consultations and treatments at accredited medical facilities, the levels of entitlement to HI benefits are 100 percent, 95 percent and 80 percent based on a set of stipulated criteria. For medical services provided by non-accredited medical facilities, benefits are capped at 70 percent, 50 percent and 30 percent of the treatment fees. In cases where the expenses are initially paid for by the participants, including treatment provided overseas, the expenses can be reimbursed but are capped at stipulated amounts.

The health insurance fund may compensate contracted health care providers for their services or directly reimburse the covered person. Methods of payment for health care providers include capitation, fee for service and DRGs. The fund provides co-payment to covered persons excluding children under six years of age, privileged people and members of the armed forces.

Source: ASSA News Volume 20, 2009; http://english.vietnamnet.vn/social/2009/01/822666; PriceWaterhouseCoopers, Vietnam News Brief, 29 September 2009; Deloitte, Update on Health Insurance, October 2009

Implementation date: 07.2009