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From July 1, changes to Health Insurance (BHYT) rules will take effect, including a new monthly wage base used to calculate copayment limits and an updated standard for when patients receive 100% coverage for eligible treatment costs within the year.
Many people assume that holding a BHYT card with “5 years continuous” automatically guarantees 100% coverage for treatment costs. However, under the BHYT framework, the five-year period is generally only a necessary condition, not a sufficient one.
In most cases, BHYT covers 80% of costs on the approved list, while the patient pays the remaining 20% (the copayment). Only certain groups receive 95% or 100% subsidies from the outset.
For the large group covered at 80%, to upgrade to 100% for multiple visits within a year, the patient must meet all three conditions at the same time. The “5-year continuous BHYT” requirement is one of those conditions.
Because the base salary changes, the formula for the out-of-pocket cap also changes. From July 1, the out-of-pocket cap increases to 15.18 million dong.
According to the new rule, when a person has 5 consecutive years of BHYT enrollment and receives services through the proper channels, they will continue paying 20% of costs as usual. Once the total out-of-pocket payments accumulate beyond 15.18 million dong within the year, subsequent eligible visits will be covered 100% by BHYT (within the entitlement).
Previously, once the threshold was reached, patients had to collect invoices and documents and submit them to BHXH to process reimbursements, which could take time.
BHXH Vietnam says this process has been removed. An automatic coordination mechanism between BHXH and hospitals has been established to protect patients’ rights: the BHXH information system updates and accumulates a patient’s out-of-pocket payments in real time and determines precisely when the threshold is crossed. This data is linked on the national information portal, and hospitals use it to apply the 20% exemption automatically at the point of billing.
The reform is intended to reduce paperwork for citizens and allow them to receive treatment without needing prior approval or reimbursement procedures once the threshold is met.
Ready Card users outside the European Economic Area have reportedly faced an abrupt service halt after a transition involving the card issuer disrupted the USDC spending product, according to user notices shared on X.
A notice shared…
