Hanoi (VNA) – A series of new regulations on social and health insurance took effect on July 1, 2026, marking an important step in improving social security policies and expanding access to benefits and services.
The changes cover contribution and benefit levels based on the new statutory pay rate, reflecting a more people-centred approach to the social security policy. They are expected to make it easier for insurance participants to access healthcare and strengthen the social security safety network.
62 diseases eligible for direct access to specialised care
The amended Law on Health Insurance, which took effect on July 1, introduces changes to maximise benefits while removing unnecessary administrative barriers for patients.
A key measure is Circular No. 01/2026/TT-BYT issued by the Ministry of Health, which lists 62 diseases and disease groups for which patients can go directly to specialised medical facilities for treatment without a referral.
The list includes serious and rare diseases as well as conditions requiring advanced medical techniques, including cancer, blood, cardiovascular and neurological diseases, metabolic disorders and organ transplants.
Removing referral requirements is expected to save patients time and travel costs while giving them earlier access to advanced treatment at leading hospitals.
The scope of health insurance coverage and the conditions for reimbursement have also been revised to provide greater flexibility, particularly for patients with serious or long-term illnesses.
Digital transformation is also helping simplify access to health insurance services. Data connectivity between the social insurance and health sectors allows people to use their chip-based citizen ID cards or electronic applications such as VssID and VNeID when seeking medical care, reducing paperwork and waiting time.
The adjustment of the statutory pay rate to 2.53 million VND per month under Decree No. 161/2026/ND-CP also affects health insurance benefits. Health insurance funds now cover 100% of costs for a medical visit or treatment episode when total expenses are below 15% of the statutory pay rate, raising the threshold to 379,500 VND.
Social insurance policies have also been adjusted since July 1, with a focus on improving the living standards of pensioners and people receiving monthly benefits.
Under Decree No. 162/2026/ND-CP, pensions and social insurance benefits have increased by 8%. For people whose benefits remain at or below 3.5 million VND per month after the increase, an additional 300,000 VND will be provided, bringing the monthly benefit to 3.8 million VND.
The policy is intended to narrow income gaps among beneficiaries and provide greater support for those with low pensions amid changes in living costs.
Other short- and long-term social insurance benefits have also been adjusted in line with the new statutory pay rate. The one-off allowance for childbirth or adoption, for example, has increased to 5.06 million VND per child, while the funeral allowance has risen to 25.3 million VND.
The new policies are expected not only to improve benefits for current participants but also to encourage wider coverage of social and health insurance.
For informal-sector workers, the State continues to provide financial support for voluntary social insurance contributions, encouraging people to build up contribution periods towards future pensions and health insurance coverage in old age./.
