Health insurance in Vietnam is primarily structured into two categories: Social Health Insurance (SHI) and Private Health Insurance (PHI). SHI, managed by Vietnam Social Security (VSS), is mandatory for employees, students, and civil servants, covering basic medical services like outpatient and inpatient care, chronic disease management, and maternity services. The government subsidies SHI for vulnerable groups such as children, the elderly, and the poor, ensuring basic healthcare access for these populations. It is funded through contributions shared between employers and employees, making up a total of 4.5 percent of the employee’s salary.
Private Health Insurance, on the other hand, is voluntary and provides additional coverage that goes beyond the scope of SHI. It includes benefits such as private hospital stays, dental and optical services, and international medical coverage. PHI is typically purchased by expatriates, high-income individuals, and companies seeking comprehensive health benefits for their employees. While PHI offers higher quality care and shorter wait times, it is not widely accessible due to higher premiums.
Notably, there is room for improvement with several initiatives underway. These include expanding SHI coverage to the entire population by 2025, improving healthcare infrastructure, and regulating PHI to ensure affordability and transparency. Despite these efforts, challenges remain, such as the underutilization of SHI benefits in rural areas, overcrowding in public hospitals, and high out-of-pocket costs for uncovered services.
Social Health Insurance (SHI) in Vietnam: An Overview
Social Health Insurance (SHI) is a government-mandated program managed by the Vietnam Social Security (VSS) system. It aims to provide universal healthcare coverage for all Vietnamese citizens and certain groups of foreign residents, ensuring equitable access to essential health services. SHI is a fundamental part of Vietnam’s social security system, designed to protect individuals against the financial risks of illness, injury, and other health-related issues.
Key Features of SHI
Mandatory Participation
SHI is compulsory for employees, employers, and specific population groups, including civil servants, students, and the poor. Employers and employees share the cost of SHI contributions, making it accessible for most of the population. The government subsidises contributions for vulnerable groups such as children under six, the elderly, and the economically disadvantaged.
Contribution Rates
The total contribution rate for SHI is 4.5 percent of an employee’s monthly salary. This is split between the employer, who contributes 3 percent, and the employee, who contributes 1.5 percent. For students, retirees, and others not in formal employment, the government may provide full or partial subsidies to cover their contributions.
Coverage and Benefits
SHI provides coverage for a broad range of health services, including:
- Outpatient and inpatient care at public healthcare facilities.
- Maternity care and child health services.
- Chronic disease management and rehabilitation services.
- Diagnostic tests, medical procedures, and surgeries.
- Prescription medications, with a reimbursement rate depending on the specific drug and condition.
- Preventive services, including vaccinations and health check-ups.
Although SHI provides extensive coverage, there are limitations in areas such as dental care, optical services, and high-cost treatments like specialised surgeries or advanced cancer therapies.
SHI Challenges and Reforms
Challenges
- Underutilization and Awareness: Many people, especially in rural areas, are not fully aware of their SHI entitlements or do not understand how to access their benefits effectively.
- Overcrowding in Public Hospitals: The majority of SHI-covered services are provided at public hospitals, leading to overcrowding, long wait times, and variable quality of care.
- Limited Coverage for Certain Treatments: High-cost or specialised treatments may not be fully covered by SHI, resulting in significant out-of-pocket expenses for patients.
Reforms
The Vietnamese government wants to improve the SHI system through several initiatives, including:
- Expanding SHI Coverage: Aiming to achieve 100 percent coverage by 2025 through increased participation and targeted subsidies.
- Improving Healthcare Infrastructure: Investing in public healthcare facilities to reduce overcrowding and improve the quality of services.
- Enhancing SHI Benefits: Expanding the range of services covered under SHI and increasing reimbursement rates for high-cost treatments.
Social Health Insurance is a vital component of Vietnam’s healthcare system, providing a safety net for millions of people. Continued reforms and investments are necessary to address existing challenges and ensure that SHI can meet the healthcare needs of the entire population effectively.
Private Health Insurance in Vietnam
Private health insurance (PHI) in Vietnam offers additional healthcare coverage beyond the basic services provided by Social Health Insurance (SHI). It is designed to meet the needs of individuals seeking higher-quality healthcare services, faster access to treatments, and more extensive benefits. PHI is especially popular among expatriates, high-income individuals, and companies offering comprehensive health benefits to their employees.
Coverage and Benefits
Private health insurance plans in Vietnam provide a wide range of coverage options, which can include inpatient and outpatient care, specialist consultations, dental and optical services, maternity care, and even international medical coverage. Many plans also offer benefits such as emergency medical evacuation and direct billing at private hospitals, allowing policyholders to access high-quality care without the need for upfront payments. This extensive coverage makes PHI an attractive choice for those looking for more comprehensive health protection and peace of mind.
Cost and Premiums
The cost of private health insurance in Vietnam varies depending on several factors, including the age and health condition of the insured, the level of coverage selected, and the insurance provider. Annual premiums typically range from a few hundred to several thousand U.S. dollars. While these premiums may seem high compared to SHI contributions, they provide access to a broader range of services and more personalised care. For expatriates, international plans can also cover treatments abroad, adding further value to the investment in private health insurance.
Advantages of Private Health Insurance
Private health insurance offers several benefits, including access to private hospitals and international clinics, where patients can expect shorter wait times and more personalised care. Policyholders can choose from a wide network of healthcare providers, ensuring flexibility and convenience in selecting where to receive treatment. Additionally, many PHI plans include coverage for services not typically covered by SHI, such as dental and optical care, and provide better accommodations during hospital stays.
Challenges and Limitations
Despite its benefits, private health insurance in Vietnam is not without challenges. The high cost of premiums can make it inaccessible to the majority of the population, limiting its use to those who can afford it or whose employers provide it as part of their benefits package. Additionally, understanding the various plans and coverage options can be complex, leading to potential confusion and difficulty in selecting the most suitable plan. Some plans may also have exclusions or limitations, particularly concerning pre-existing conditions or high-risk activities, which can reduce the effectiveness of the coverage.
Key private health insurance providers in Vietnam
Key private health insurance providers in Vietnam include both local and international companies. These providers offer a range of health insurance plans catering to individuals, families, and businesses, often including extensive benefits and international coverage. Below are some of the main private health insurance providers in Vietnam:
Bao Viet Insurance
Bao Viet is one of the largest and most well-established local insurance companies in Vietnam. It offers a variety of health insurance products designed for individuals and families, as well as corporate group insurance. Bao Viet’s health plans cover both inpatient and outpatient care, and their extensive network of hospitals and clinics across Vietnam makes it a popular choice for residents.
PVI Insurance
PVI Insurance provides comprehensive health insurance plans for individuals, families, and companies. Their products include options for high-quality medical services in Vietnam and abroad, with coverage for hospitalisation, surgeries, maternity care, and chronic disease management. PVI is known for its flexible and customizable insurance plans, which are tailored to meet diverse customer needs.
Liberty Insurance
Liberty Insurance, a subsidiary of the global Liberty Mutual Group, offers a wide range of health insurance products, including individual, family, and corporate plans. Their health insurance policies are known for providing extensive coverage options, including outpatient, inpatient, maternity care, and emergency medical evacuation. Liberty also offers direct billing at many hospitals, which is convenient for policyholders.
Aetna International
Aetna is an international health insurance provider offering extensive coverage for expatriates living in Vietnam. Their plans are designed to provide comprehensive health benefits, including coverage for inpatient and outpatient care, dental and vision services, and global medical assistance. Aetna’s focus on expatriates makes it a preferred choice for those seeking international healthcare coverage and support.
Allianz Worldwide Care
Allianz provides international health insurance plans for expatriates and Vietnamese citizens. Their coverage includes inpatient and outpatient services, emergency evacuation, dental and vision care, and wellness benefits. Allianz is known for its robust global network of healthcare providers, making it an ideal choice for those who travel frequently or prefer international healthcare standards.
Pacific Cross Vietnam
Pacific Cross offers a variety of health insurance products, including plans specifically tailored for expatriates, Vietnamese families, and corporate groups. Their policies cover a wide range of medical expenses, including hospitalisation, outpatient treatments, dental care, and emergency evacuation. Pacific Cross is known for its responsive customer service and extensive network of healthcare providers in Vietnam and the region.
Generali Vietnam
Generali provides comprehensive health insurance plans that include coverage for both local and international medical services. Their policies cover hospitalisation, surgery, outpatient treatments, and preventive care. Generali’s health plans are popular among high-income individuals and businesses looking for high-quality healthcare coverage and services.
What’s next?
As the demand for quality healthcare continues to grow, the private health insurance market in Vietnam is expected to expand. With increasing competition among insurers, more diverse and affordable options may become available, making private health insurance more accessible to a broader segment of the population. Additionally, as Vietnam’s healthcare system modernises and integrates more advanced services, private health insurance will likely play an essential role in complementing the public health system and enhancing overall healthcare quality in the country.
With this in mind, foreign insurance firms considering entering the Vietnam market should make sure to keep up to date with the latest developments in Vietnam’s insurance industry by subscribing to the-shiv.