In recent years, the number of foreigners coming to live, study, and work in Vietnam has been steadily increasing, leading to greater demand for social security benefits, including health insurance. Below, NPLaw would like to provide readers with an overview of the legal issues relating to health insurance for foreigners in Vietnam.

I. Current situation of health insurance for foreigners in Vietnam

At present, participation in health insurance for foreigners residing and working in Vietnam still faces numerous challenges. Although the law provides that foreign employees working under employment contracts are subject to mandatory health insurance, the participation rate remains relatively low. The main reasons include lack of information, language barriers, and non-compliance by certain employers.

Additionally, other groups of foreigners such as dependents, international students, or long-term temporary residents are not subject to mandatory participation, nor are there clear guidelines on voluntary participation. Consequently, many foreigners don't enjoy adequate health care protection in the event of medical risks. Such a situation highlights the urgent need to further improve health insurance policies to expand coverage and ensure fairness in health services between foreigners and Vietnamese citizens.

II. Understanding of health insurance for foreigners?

1. Definition

According to Clause 1, Article 1 of the Law on Health Insurance as amended in 2014, health insurance is defined as a compulsory form of insurance applied to the entities specified by the Law to receive health care without profit aims, organized by the State.

Accordingly, health insurance for foreigners is a State-organized mechanism to ensure health care protection for foreigners who legally reside, study, and work in Vietnam.

2. Is it difficult for foreigners to participate in health insurance?

Implementation of health insurance for foreigners in Vietnam remains complicated due to both legal and practical factors, such as:

  • Lack of detailed guidelines: Agencies, organizations, employers, and foreigners often have difficulties in determining entitlements, participation procedures, contribution rates, and payment methods.
  • Language and information troubles: Foreigners often lack clear understanding of the regulations, resulting in reluctance to participate or failure to fully cognize their entitlements.
  • Quality of services and health facilities: Some foreigners hesitate to use public health services due to differences in service standards or concerns about communication barriers.

3. Are foreign employees in Vietnam required to participate in health insurance?

Pursuant to Articles 1 and 5 of Decree No. 146/2018/ND-CP, as amended by Decree No. 104/2022/ND-CP, foreigners are required to participate in health insurance if they:

  • Have an employment contract of at least 3 months; or
  • Have an indefinite-term employment contract; or
  • Serve as enterprise managers or cooperative executives who receive salaries.

In such cases, the employer takes responsibility for registering and contributing health insurance for their foreign employees.

III. Legal provisions on health insurance for foreigners

1. Main regulations

Under Articles 1 and 5 of Decree No. 146/2018/ND-CP, foreigners are obliged to participate in health insurance if they fall into the following categories:

  • Having an employment contract of at least 3 months;
  • Having an indefinite-term employment contract;
  • Working as salaried enterprise managers or cooperative executives.

Foreigners not subject to mandatory participation may voluntarily enjoy health insurance if they:

  • Are registered in a household book or have a valid temporary residence certificate;
  • Join through the household-based participation at the place of residence.

2. Foreigners’ rights under health insurance 

According to Article 21 of the Law on Health Insurance 2008 (as amended in 2014), foreigners covered by health insurance are entitled to the same benefits as Vietnamese citizens, including:

  • Outpatient and inpatient treatment, functional rehabilitation, pregnancy check-ups and childbirth;
  • Screening and early diagnosis of certain diseases;
  • Transportation costs from district-level to higher-level hospitals in emergency cases or where inpatient treatment requires transfer, applicable only to priority groups such as people with meritorious services, poor households, children under 6, and ethnic minorities in disadvantaged areas.

Other rights, as guided by the Ministry of Health, include:

  • Medicines, chemicals, and medical supplies on the approved list;
  • Medical services such as laboratory tests, diagnostic imaging, surgery, and physiotherapy.

The level of health insurance depends on the category of insured person, the hospital level, and whether treatment is sought within or outside the designated network.

3. Procedures for participating in health insurance for foreigners

Pursuant to Article 17 of the Law on Health Insurance 2008 (as amended in 2014), the procedures include the following dossier:

  • For foreigners under mandatory insurance (through employers):
    + Application for participation of the enterprise (as per form);
    + List of foreign employees (Form D02-TS);
    + Individual declaration form (Form TK1-TS);
    + Copy of employment contract with a term of at least 3 months.
  • For foreigners under voluntary insurance (household-based):
    + Individual declaration (Form TK1-TS);
    + Household list (Form DK01);
    + Copy of household book or valid temporary residence certificate;
    + Copy of passport or valid residence card.

Time for issuance: Within 10 working days from receipt of a valid application, the Social Insurance Authority must issue the health insurance card.

4. Necessary matters for health insurance for foreigners

To avoid violations, foreigners should take note of the following:

  • Not using another person’s health insurance card;
  • Providing accurate personal details (passport, residence permit, employment contract, etc.);
  • Avoiding to purchase insurance from unofficial sources;
  • Promptly updating any changes in residence, employment status, or departure from Vietnam with the Social Insurance Authority.

IV. Questions on health insurance for foreigners

1. What risks do foreigners take if they don’t enjoy health insurance? 

Foreigners without health insurance may take:

  • High medical expenses, especially for major illnesses requiring hospitalization or surgery;
  • Lack of support for referrals or emergency admissions;
  • Possible refusal of treatment at public facilities if unable to pay immediately;
  • Ineligibility for Vietnam’s social health protection regime, affecting long-term security.

2. What types of health insurance are available?

Foreigners may participate in:

  • Mandatory health insurance (through employment);
  • Voluntary health insurance (household-based).

3. Are employment contracts required for foreigners to purchase health insurance?

According to the provisions of Articles 1 and 5 of Decree 146/2018/ND-CP, amended by Decree 104/2022/ND-CP, foreigners are obliged for or without labor contracts, specifically:

  • For mandatory health insurance: Health insurance is required for contracts of at least 3 months or indefinite-term. In such cases, employers must register and pay contributions.
  • For voluntary health insurance: Foreigners without employment contracts may still enjoy health insurance if they have legal household registration or temporary residence in Vietnam.

4. How long is the processing time?

According to Clause 3, Article 17 of the Law on Health Insurance 2008 (as amended in 2014), health insurance cards must be issued within 10 working days of submission of a valid application.

5. Are contributions refundable if insurance is not used?

According to Article 20 of Decision No. 595/QD-BHXH (amended by Decision No. 505/QD-BHXH), refunds are only available in the following cases:

  • Change of insured group resulting in cancellation of previously issued cards;
  • Increased State budget support;
  • The insured person passes away before the card takes effect.

Therefore, contributions are not refundable if the insured person does not use the card during its validity period.

V. Why seek legal counsel on health insurance for foreigners?

The foregoing is NPLaw’s overview of health insurance for foreigners. With a team of experienced lawyers and legal specialists, NPLaw is always ready to advise and support clients on legal matters relating to health insurance for foreigners in Vietnam. For assistance, please contact NPLaw.