The 2024 overhaul of the health insurance law

Health cover in Vietnam rests on the compulsory scheme set by the Law on Health Insurance, first passed in 2008 and amended several times. The latest amending law, Law No. 51/2024/QH15, was passed on 27 November 2024, and most of it took effect on 1 July 2025. The scheme is administered through the national social security agency.

Law-firm summaries of the amended law list the changes a member notices. Each participant has a single health insurance code, and the card can be shown through the VssID or VNeID apps or the chip citizen ID, with electronic and paper cards carrying equal legal value. A member registers an initial treatment facility, which can now be anywhere in the country, and can switch once a quarter during its first 15 days. Home-based treatment is covered as well. At a registered facility, Tuoi Tre News reports, the fund pays from 80% up to the full cost of care, depending on the person’s category and where they are registered.

The three tests for a foreign worker

In April 2026, Ho Chi Minh City’s social security office reminded employers that foreign workers must be enrolled, and Tuoi Tre News set out when that applies. A foreign employee joins national health insurance when they fall under compulsory social insurance, which means three things together: a labour contract of at least one year, a work permit (or a practice certificate or exemption), and work for an enterprise, organisation or representative office in Vietnam.

Older guides cite a three-month contract threshold for foreigners. Sources describing the rules in force from 1 July 2025, including a 2025 consultancy update, put it at 12 months or more, against one month for Vietnamese employees.

How the 4.5% contribution is shared

The contribution is 4.5% of the monthly salary used for social insurance. The employer pays 3% and the employee 1.5%. The employer withholds the employee’s portion from wages and pays the whole contribution to the scheme.

Missing an enrolment is costly. Tuoi Tre News reports that employers who fail to enrol foreign workers face administrative penalties, along with back contributions and late-payment interest.

Licensing limits on foreign insurers

Vietnam’s Law on Insurance Business 2022 (Law No. 08/2022/QH15, in force from 1 January 2023) allows insurance to be offered in the country only under a Vietnamese licence, apart from cross-border services allowed by Vietnam’s international treaties. Decree 46/2023/ND-CP, as Viet Nam News reported it, narrows those cross-border cases further. Only foreign-invested organisations and foreigners working in Vietnam may buy such cover. The foreign insurer must be licensed in its home country, have operated legally for at least 10 years, hold assets of at least two billion US dollars and pass credit-rating and profit tests. It may sell only through an insurance broker licensed in Vietnam.

With cross-border cover this narrow, do not assume a global health plan can be bought from abroad for a Vietnam-based employee. Whether health insurance is among the classes allowed cross-border is for the insurer to confirm.

Private cover alongside the national scheme

For an employee who meets the three tests, an international plan cannot stand in for national health insurance; the employee must hold the compulsory cover whatever else is added, and any private policy sits on top of it. On tax, a Customs newspaper explainer of Vietnamese guidance says health insurance an employer buys for staff is not counted as taxable employment income when the product does not compulsorily accumulate premiums, while savings-type life products are treated differently. The circulars behind that guidance have been amended, so check with a local adviser before you set up a policy as a benefit.

Work permits and the employer of record route

Decree 152/2020/ND-CP governs foreigners working in Vietnam. Consultancy guides describe work permits lasting up to two years, renewable once, and define a foreign company’s commercial presence as a Vietnamese entity, branch or representative office.

The same guides say a US company with no presence in Vietnam usually hires through an employer of record, which signs the local labour contract, sponsors the work permit and registers the employee for health and social insurance. Your company then decides what to add above the national scheme.

Asking us for a partner introduction

Use the quote form on this page to tell us where in Vietnam your staff are based, the number of people, the length of their contracts and whether they work through an employer of record or your own entity. We can introduce you to a benefits partner that focuses on health coverage for employees working outside the US. The partner and the insurer decide who is eligible, which options are available and what they cost, and Mithril1 stays your contact for business insurance.

A few useful answers

Common questions

When does a foreign employee in Vietnam have to join national health insurance?

When they fall under compulsory social insurance: a labour contract of at least 12 months, a work permit or recognised exemption, and work for an organisation in Vietnam. Sources on the rules in force from 1 July 2025 give that test; older guides cite three months.

How much does an employer pay toward Vietnamese health insurance?

The contribution is 4.5% of the salary used for social insurance. The employer pays 3% and withholds the employee’s 1.5% from wages.

Can a foreign insurer sell health cover directly to an employee in Vietnam?

Insurance in Vietnam generally needs a Vietnamese licence. Decree 46/2023 allows some cross-border cover through a broker licensed in Vietnam; whether health is one of the classes it reaches is for the insurer to confirm.

Can the employee choose where to get treatment?

They register an initial treatment facility, which can be anywhere in the country, and may change it once a quarter within the first 15 days.

International Health Insurance for Remote Employees in Vietnam