Consolidated Document No. 40/VBHN-VPQH: Health Insurance Law (Consolidated Through 2026)

Introduction

Consolidated Document No. 40/VBHN-VPQH, issued by the National Assembly Office and published on March 31, 2026, merges the original Health Insurance Law No. 25/2008/QH12 (effective July 1, 2009) with eight subsequent rounds of amendments, most recently Law No. 51/2024/QH15 (effective July 1, 2025) and the Prevention Law No. 114/2025/QH15 (effective July 1, 2026). This is not a new law - it is the official consolidated reference text that lets businesses and practitioners look up current health insurance rules in a single document instead of cross-referencing multiple amending laws.

Scope and application

The law governs health insurance policy: who must participate, contribution levels, payment responsibility and methods, health insurance cards, coverage scope, healthcare organization, cost settlement, the health insurance fund, and the rights and duties of related parties. It applies to domestic and foreign organizations and individuals in Vietnam connected to health insurance, but excludes commercial, for-profit health insurance.

Principles and state policy

Health insurance operates on risk-sharing among participants; contribution levels are set as a percentage of salary, pension, allowance, or a government-set reference amount; benefit levels depend on illness severity, participant group, and years of participation; the fund is managed centrally, transparently, and with balanced revenue and expenditure. The State pays or subsidizes contributions for people with meritorious service and certain social groups, offers investment incentives to grow the fund, and encourages technology adoption in fund management.

State management responsibilities

The Government exercises unified management. The Ministry of Health leads, issuing policy, the basic health service package, and technical guidance. The Ministry of Finance oversees the fund's financial regime. The Ministry of Labor - Invalids and Social Affairs and the Ministry of Education and Training manage their respective participant groups. The Ministry of National Defense and the Ministry of Public Security manage armed-forces-related participants. People's Committees at all levels handle local implementation and household-based participant registration. The State Audit Office audits the fund every three years and reports to the National Assembly.

Prohibited acts

The law bans late payment or evasion of health insurance contributions; fraud or forgery of records and health insurance cards; misuse of contributions or fund assets; obstructing participants' lawful rights; false reporting; and abusing position, authority, or expertise to violate health insurance rules.

Who must participate (Article 12)

Six participant groups:

• Employer/employee-funded group: staff on labor contracts of one month or more, foreign employees on contracts of 12 months or more, registered household business owners, civil servants and public employees, and unpaid company or cooperative managers.
• Social insurance agency-funded group: pensioners, work-injury or occupational-disease allowance recipients, and unemployment benefit recipients.
• State-budget-funded group: military and police personnel, people with meritorious service, children under 6, National Assembly and People's Council delegates, next of kin of fallen soldiers, and other listed groups.
• State-subsidized group: near-poor households, students, grassroots security forces, and average-income farming, forestry, fishing, or salt-making households.
• Self-funded group: household-registered participants, people in charity or religious institutions, and employees on unpaid leave or suspended contracts.
• Other groups as further defined by the Government.

Contribution rates and responsibility (Article 13)

The monthly contribution is capped at 6 percent of monthly salary, or pension, allowance, or reference amount depending on the group. For contract employees, the employer pays two-thirds and the employee pays one-third. Household business owners and unpaid managers pay the full amount themselves. State-budget groups have contributions paid entirely from the budget; subsidized groups pay the remainder after a partial state subsidy.

Advance payments and settlement for medical costs (Article 32)

The social insurance agency advances 90 percent of quarterly treatment costs to healthcare facilities based on the prior quarter's settlement report; newly contracted facilities receive a 90 percent advance for their first month. Settlement between facilities and the agency runs on a monthly cycle within the first 15 days of each month.

Note on document coverage

The source text is cut off partway through Article 32, Section 2 on medical cost settlement, so later provisions - penalty enforcement and the law's implementation clauses - are not included in this excerpt. Health insurance card rules (Article 16) and benefit levels (Article 22) are fully present earlier in the source, ahead of Article 32. Businesses should consult the full text in the Official Gazette, Issue No. 172, dated March 31, 2026, for the penalty and implementation provisions.