Those from near-poor households and seniors aged 75 and above receiving social pension benefits qualify for full reimbursement of medical examination and treatment costs under Vietnam's health insurance system from January 1, 2026, according to a resolution passed by the National Assembly on December 11, 2025, the Ministry of Health said.
In compliance with the resolution, the ministry on January 6 issued an urgent notice to the Vietnam Social Security under the Finance Ministry, provincial and municipal health departments, and medical facilities nationwide, urging prompt updates to benefit codes for the newly eligible groups.
In particular, health insurance cardholders from near-poor households have their payment rate raised from 95% to 100% of covered medical expenses effective on January 1.
Any emerging difficulties or problems are to be reported immediately to insurance evaluators and social security bodies to guarantee uninterrupted and complete benefit access.
According to the VSS, health insurance reimbursements will follow Article 22 of the 2024 Law on Health Insurance, which lists 11 groups entitled to 100% coverage of examination and treatment costs.
These include active-duty military personnel; students of the military, police and cipher services receiving stipends; standing militia members, revolution contributors and war veterans, children aged below six, relatives of martyrs, those from poor households, ethnic minorities and residents living in disadvantaged or extremely disadvantaged areas, recipients of monthly social assistance or survivor's benefits, those aged 75 and over receiving monthly survivors’ benefits; and those aged 70 to under 75 from near-poor households who are receiving monthly survivors’ benefits.
The broader eligibility and full coverage for vulnerable groups are expected to improve access to health care, lower medical spending, and underscore the humanitarian and sustainable aspects of Vietnam’s social welfare policies in the years ahead./.
