Straight to a major hospital without a referral - how Vietnam's health insurance changes from July

On July 1, the amended Health Insurance Law (BHYT) took effect in Vietnam. For 62 diseases and disease groups such as cancer and heart failure, patients with a confirmed diagnosis can now go straight to a specialist hospital without a referral, and the smartphone apps VNeID and VssID can stand in for the paper insurance card. Many Japanese working in Vietnam as local hires or on assignment are enrolled in this BHYT through their labor contracts. Most probably think, “I know it’s deducted from my salary, but I’ve never used it.” This amendment turns that dormant insurance into something usable as a safety net in the event of serious illness. We lay out the substance of the amendment and how to use it alongside foreign-invested hospitals.

What changed from July 1 — the three pillars of the revision

According to VietnamPlus, part of the state-run Vietnam News Agency, this revision has three main points.

The first isDirect access to specialist hospitals for 62 diseasesPatients with a confirmed diagnosis of a covered disease can go directly to a top-tier “specialist-level” medical institution without a referral (transfer procedure). This mechanism itself was introduced in 2025 by Ministry of Health Circular 01/2025/TT-BYT, and at the time of announcement it was reported locally that the list had grown by 20 diseases from the old one. It was then updated by Circular 01/2026/TT-BYT dated January 9, 2026.

The second isElectronic health insurance card. A chip-embedded ID card (CCCD), the social insurance app VssID, or the national ID app VNeID can each stand in for the paper BHYT card. The third isExpansion of the benefit scopeA new 50% benefit was also introduced for outpatient visits to basic-level medical institutions made without a referral. And the mechanism of “100% benefit if a single consultation costs less than 15% of the base salary” has, with the July 1 base-salary increase (2.53 million dong a month = about 15,000 yen, Decree 161/2026/NĐ-CP), seen its threshold rise to 379,500 dong (about 2,300 yen) (converted at 10,000 dong = about 60 yen, the same hereafter).

Behind this is the system's rapid expansion. BHYT enrollment reached 97.65 million, or 95.16% of the population, and 2025 saw 195.1 million visits, up 6.5% from the previous year. Fund payouts came to 166.4 trillion dong (about 1 trillion yen), of which more than 30% was drug costs. How to sustain the finances while broadening benefits has become the main battleground of Vietnam's healthcare policy.

Inside the list of 62 diseases — the precise meaning of "100% coverage"

The scope of 62 diseases and disease groups centers on areas requiring long-term, highly specialized treatment: cancer, blood disorders, cardiovascular disease, neurological disease, metabolic disorders, post-organ-transplant management, and the like. From an explainer published by Tam Anh General Hospital, a major private hospital with a BHYT contract, here are representative examples.

"100%" doesn't necessarily mean zero out-of-pocket

Local reports describe it as “100% BHYT benefit,” but strictly it means “the benefit rate set for one’s enrollment category is applied in full.” The benefit rate ranges from 80% to 100% by category, and ordinary employees including foreigners are in principle 80%. In other words, the essence is,Even if you skip the referral and go to a higher-level hospital, the benefit rate isn't reduced. Previously, the rule was that going to a higher-level hospital without following the proper referral procedure meant reduced coverage.

Coverage is limited to "care for that disease"

In the government portal's Q&A, a patient registered under the 62 diseases asked whether they could "receive specialist-level benefits even when seeing a doctor for a different illness," and the authorities answered that "the special treatment applies only to care for the listed diseases." Some diseases, like heart failure, come with severity conditions. On the other hand, if you receive a confirmed diagnosis of one of the 62 diseases for the first time at a specialist hospital, benefits apply from that visit.

Your phone becomes your insurance card — visits with VNeID and VssID

At a visit, showing any of a chip-equipped ID card, VssID, or VNeID means the paper card is no longer needed. The Vietnamese government is rapidly consolidating administrative procedures into VNeID, andImmigration procedures unified into VNeID, among others, the scope widened dramatically in this summer alone. Health insurance has ridden that wave too.

That said, for foreign residents, differences may remain in how electronic verification is run depending on the counter. Many people haven't set up a VNeID account yet, so for the time being it's realistic to also carry a paper BHYT card or a document showing your social insurance number.

Resident Japanese and BHYT - enrollment conditions, premiums, benefit rates

Let’s start from whether you are even enrolled. In Vietnam, foreigners working on a labor contract of three months or more are required to enroll in BHYT. The premium is 4.5% of monthly salary, with the company bearing 3% and the individual 1.5%. Local hires are almost automatically enrolled, and expats too are often covered if they have a labor contract with the local entity. Whether your pay slip shows a “BHYT” deduction is the clue.

This July,Revisions around income tax and pensionsandExtension of maternity leaveand other changes affecting workers came at a concentrated time. If you see the expansion of health-insurance benefits as part of this, HR and labor staff have one more list of revisions to keep on top of.

How to design the split between BHYT and foreign-invested hospitals

For Japanese residents, healthcare mainly means visiting foreign-owned or private clinics using the company's private medical insurance. You can be seen in Japanese or English, and wait times are short. Meanwhile, most people have 'never been' to the BHYT-designated public hospitals because of the language barrier and crowding. This basic picture doesn't change, but this revision shifts BHYT's position from 'insurance you don't use' to 'a trump card for serious illness.'

The approach has two tiers. Handle everyday outpatient visits and checkups quickly at foreign-affiliated or private clinics as before. If a serious diagnosis such as cancer or heart disease comes up, check whether it falls on the list of 62 diseases, and if it does, use BHYT to access specialist care without a referral at national flagship hospitals such as Bach Mai in Hanoi or Cho Ray in Ho Chi Minh City—that's the flow. For long-term, costly treatment you will compare private insurance coverage caps and returning to Japan for care, but the very fact that the "receive specialist treatment locally using public insurance" option has become more usable changes residents' risk management.

The private sector's moves are also not to be missed. Tam Anh General Hospital tells patients that "people in the 62 disease groups can be seen and treated at our hospital without transfer procedures," and the combination of "private-sector comfort × public benefits" is spreading. As a receptacle sitting between foreign-affiliated hospitals and local public hospitals, the presence of private general hospitals with BHYT contracts is likely to grow going forward.

From a company's standpoint, there's also room to review the design of private medical insurance for expatriates. The wider the range BHYT can cover, the easier it becomes to reorganize private insurance to specialize in the add-ons - Japanese-language support, private rooms, medical evacuation home.

Local reactions, and checks you can make starting today

Local interest in the expansion is high, with concrete inquiries and activity standing out.

• A reader question was posted to the government portal—"I'm registered under the 62 diseases, but can I get specialist-level coverage for visits for a different illness too?"—and the authorities answered on the scope of application
• The private Tam Anh General Hospital tells patients that those with the 62 diseases can be seen without transfer procedures, tying the system into expanding patient intake
• VietnamPlus reports that the number of medical visits in 2025 reached 195.1 million, up 6.5% year on year, with drug costs accounting for more than 30% of fund expenditure - and reporting pointing to the balance between benefit expansion and finances continues

There are four checks Japanese residents can make starting today. First, verify the BHYT deduction and your insurance number on your pay slip. Second, get your paper card's storage location and your VNeID and VssID account status in order. Third, confirm accompanying family members' enrollment with your workplace's HR. Fourth, review the coverage of your company's private medical insurance and grasp any overlaps or gaps with what BHYT covers. A serious diagnosis always comes suddenly. While the system has just expanded, take stock of at least the full picture of the insurance available to you.

Sources

• VietnamPlus: Từ 1/7 mở rộng thêm nhiều quyền lợi hơn cho người tham gia bảo hiểm y tế
• Báo Chính phủ: Q&A on the coverage scope for patients on the list of 62 diseases
• Bệnh viện Đa khoa Tâm Anh: 62 bệnh hưởng BHYT không cần chuyển viện
• Vietnam Ministry of Health: publication of the 62-disease list
• VietnamNet: BHYT cho người nước ngoài tại Việt Nam 2026