Points Foreign Workers Should Note Regarding the Revised Health Insurance Effective July 1, 2025
2025/07/24
- Huynh Minh Trang
Health insurance (BHYT) is a mandatory form of insurance regulated by the Health Insurance Law for health care, organized and implemented by the State on a non-profit basis. The goal of health insurance is to help reduce the financial burden for health insurance participants when seeking medical examination and treatment. Previously, although there were no specific regulations regarding the obligation of foreign employees working in Vietnam under labor contracts to participate in health insurance, in reality, foreign employees were among those subject to mandatory health insurance participation. In response to this situation, the amended Health Insurance Law of 2024 (hereinafter referred to as the Amended Law) will introduce many changes related to mandatory health insurance participation, clarifying the provisions for foreign employees in Vietnam. This report will summarize and analyze some points to note related to health insurance policies applied to foreign laborers according to the new regulations.
1. Participants
The 2014 Health Insurance Law does not have specific regulations for mandatory health insurance participants who are foreigners; therefore, this group is determined based on conditions equivalent to Vietnamese employees: working under an indefinite-term labor contract or a fixed-term labor contract of at least 3 months.
The amended Health Insurance Law of 2024 has clarified the subjects of foreign employees participating in compulsory health insurance and unified the participation conditions with social insurance. Accordingly, foreign employees are subject to compulsory health insurance participation when working in Vietnam under a fixed-term labor contract of 12 months or more, except for the following three cases:
・Internal transfers within the enterprise (in the form of working under a work permit)
・Having reached retirement age at the time of signing the labor contract
Retirement age is being adjusted according to the following roadmap:
・For men: in 2025, the age is 61 years and 3 months; increasing by 3 months each year until reaching 62 years in 2028.
・For women: in 2025, the age is 56 years and 8 months; increasing by 4 months each year until reaching 60 years in 2035.
・In cases where international treaties to which the Socialist Republic of Vietnam is a member have different provisions.
Currently, Vietnam has reached an agreement to avoid double social insurance contributions with South Korea and is currently negotiating with Japan.
Additionally, the law stipulates the inclusion of two more groups required to participate in compulsory health insurance as follows:
(1) Business managers, representatives of the enterprise’s capital share, members of the Board of Directors, General Directors, Directors, members of the Supervisory Board, or supervisors who do not receive salaries;
(2) Employees working under indefinite-term labor contracts or fixed-term labor contracts of one month or more, working part-time, with monthly wages equal to or higher than the minimum wage for compulsory social insurance contribution.
The amended Health Insurance Law does not clarify whether these groups include foreign workers, and there are no additional guidelines regarding wages or participation methods for Group 1 (those not receiving wages), nor is there a specified “minimum wage base for social insurance contributions” to identify Group 2 (part-time workers). Therefore, businesses should take care to verify with the relevant insurance authorities before implementation.
In the case of foreign workers signing multiple labor contracts with multiple employers, according to the current 2014 Health Insurance Law, health insurance is participated according to the labor contract with the highest salary level. However, under the amended law, participation in health insurance in this case will follow the labor contract for social insurance participation (that is, participating in social insurance and health insurance according to the first labor contract signed). This is also a new point in the amended Health Insurance Law compared to the old regulation.
2. Participation rate and salary for health insurance contribution calculation
In the case where foreign employees are eligible to participate in Health Insurance, the monthly participation rate is 4.5%, with the employer contributing 3% and the employee contributing 1.5%, similar to Vietnamese employees.
Below is the table of participation rates for mandatory social insurance types, including Health Insurance applicable to foreign employees:
| Mandatory insurance regimes | Company contribution | Foreign employee contribution | |
| Social insurance | Retirement | 14% | 8% |
| Sickness – Maternity | 3% | – | |
| Occupational accident – Occupational disease | 0,5% | – | |
| Health insurance | 3% | 1,5% | |
| Total | 20,5% | 9,5% | |
| 30% | |||
The monthly salary for mandatory health insurance and social insurance contributions is the salary on the labor contract with Vietnamese companies, including:
・Salary based on the job or position;
・Salary allowances to compensate for factors such as working conditions, job complexity, living conditions, and labor attraction that have not been considered or have been inadequately considered in the agreed salary in the labor contract;
・Additional amounts that specify a specific monetary value along with the salary agreed upon in the labor contract and are paid regularly in each pay period.
Usually, the allowance components considered for health insurance contributions for foreign diplomats include: responsibility allowance, position allowance, etc. The allowances and supplements not subject to health insurance contributions include: one-time regional transfer allowance, airfare, bonuses based on business production results; meal allowances, travel allowances, telephone bills, housing allowances, tuition for children, etc.
According to regulations, the maximum monthly salary used to calculate health insurance contributions is 20 times the reference level, and the currently applied reference level temporarily from July 1, 2025, is the basic salary of 2,340,000 VND/month; therefore, the maximum salary for calculating health insurance contributions will be 46,800,000 VND/month. The reference level will be set by the Government and adjusted based on the growth of the consumer price index and the economy, ensuring alignment with the state budget and insurance fund.
3. Benefits and entitlement regimes
Foreign migrant workers participating in health insurance will be issued health insurance cards and enjoy the benefits within the scope of health insurance coverage when receiving medical examination and treatment at Vietnamese healthcare facilities, similar to Vietnamese workers, as follows:
・In emergency cases (within/outside the network): Health insurance pays 80%, the insured pays 20%.
・In the case of treatment within the network (outpatient/inpatient): Health insurance pays 80%, the insured pays 20%.
・In the case of treatment outside the network (inpatient): depending on the classification of the medical facility, typically health insurance pays 40%, the insured pays 60%.
After reporting an increase in insurance, the company is responsible for registering the initial medical examination and treatment facility (KCB) for the foreign employee based on the list of KCB facilities issued at the time of registration. The name of this initial KCB facility will be recorded on the health insurance card (BHYT). When the foreign employee goes for a medical examination at the KCB facility recorded on the BHYT card, it is considered an in-line examination; visiting other KCB facilities is considered out-of-line.
Note: BHYT does not pay for outpatient treatment when conducted out-of-line or for periodic health check-ups/general health examinations.
Regarding the scope of benefits, when using the health insurance card for medical examination and treatment, employees will be reimbursed for costs within the scope of benefits such as: medical technical services, drugs, medical equipment, blood, blood products, medical gases, materials, tools, instruments, and chemicals used in medical examination and treatment that fall within the payment coverage of the health insurance fund.
In reality, foreign workers often rarely seek medical examinations and use health insurance benefits at public hospitals in Vietnam due to concerns about service quality, language barriers, and unclear understanding of their entitled benefits, so they mostly still receive medical examinations and treatment at international facilities.
Conclusion
In this report, we have summarized some new regulations as well as notes regarding health insurance for foreign workers in Vietnam.Before the amended Health Insurance Law of 2024 officially takes effect on July 1, 2025, enterprises employing foreign workers need to note the update on these regulations to ensure compliance with the law and to guide foreign workers in exercising their health insurance rights.
Reference:
・Health Insurance Law 2014
・Amended Health Insurance Law 2024
・Decree 135/2020/ND-CP
・Decree 73/2024/ND-CP
・Circular 06/2021/TT-BLDTBXH
This report was translated by Yarakuzen.
