Under the 2024 Law on Health Insurance, the following groups are entitled to full coverage of health insurance examination and treatment costs:
-Active Armed Forces and Equivalent Personnel include officers, professional non-commissioned officers, and soldiers serving in the People's Army; officers and technical non-commissioned officers in the People's Public Security; and individuals working in cryptography who receive military-equivalent salaries.
-Armed Forces Students: Eligible individuals include non-commissioned officers and soldiers of the People's Army on active duty, non-commissioned officers and conscripts in the People's Public Security, Vietnamese and foreign military, police, and cryptography students who receive living expenses; plus, reserve officer trainees undergoing training for three months or longer, provided they are not yet covered by social or health insurance.
Additional beneficiaries under the 2024 Law on Health Insurance entitled to full coverage of examination and treatment costs include regular militia members, revolutionary contributors and veterans, children under 6 years old, relatives of martyrs and individuals recognized for nurturing martyrs, members of poor households and ethnic minorities in ethnic minority and mountainous communes or villages or in areas with difficult socio-economic conditions, residents of specially disadvantaged areas, including island communes and island districts.
Furthermore, recipients of monthly social allowances, including individuals receiving monthly care allowances as prescribed by law, those receiving monthly death benefits who also qualify for social assistance, persons aged 75 and above receiving monthly death benefits and persons aged 70 to under 75 in near-poor households receiving monthly death benefits.
Furthermore, the 2024 Health Insurance Law, in addition to the aforementioned groups, also outlines specific instances where the Health Insurance Fund will fully cover costs. Those having medical examination and treatment expenses that are below the threshold set by the Government will enjoy free medical examination and treatment. In addition, patients's medical fee will be covered by the Health Insurance Fund if they undergo healthcare checks at primary healthcare facilities which include medical stations, family healthcare facilities, military-civilian medical stations, military-civilian clinics, medical centers in districts and medical facilities within the army and police as specified by the Minister of National Defense and the Minister of Public Security.
Additionally, all of outpatient medical examination and treatment costs at regional polyclinics are covered.
The 2024 Law on Health Insurance significantly expands patient rights, ensuring 100 percent health insurance coverage for medical examination and treatment costs even when patients seek care at healthcare facilities which are not facility of their first choice, under the following specific circumstances:
- Serious and Rare Diseases: Patients diagnosed with certain serious or rare diseases requiring surgery or high-technology treatments, as regulated by the Ministry of Health, when receiving care at basic or specialized medical facilities.
- Vulnerable Populations (Inpatient Care): Ethnic minorities and individuals from poor households residing in socio-economically disadvantaged or extremely difficult areas, as well as residents of island communes and districts, when admitted for inpatient treatment at specialized medical facilities.
- Primary and Basic Level Care:
- Medical examinations and treatment at a primary-level facility.
- Inpatient treatment at a basic-level facility.
- Pre-2025 Designated Facilities:
- Medical examination and treatment at basic and specialized facilities officially classified as district-level by competent authorities before January 1, 2025.
- Inpatient treatment at specialized medical examination and treatment facilities officially classified as provincial-level by competent authorities before January 1, 2025.
