Expected to exempt basic hospital fees for priority groups from 2026

Patients pay 21.5 trillion VND/year in hospital fees themselves

The workshop on orientation for developing a project to gradually implement the policy of free hospital fees was held by the Ministry of Health on the afternoon of December 1.

- Ảnh 1. — From 2026, basic hospital fees will be exempted in health insurance benefits for patients in priority groups.

At the workshop, Ms. Tran Thi Trang, Director of the Department of Health Insurance (Ministry of Health), said that from 2030, basic hospital fees will be exempted for health services paid for by the Health Insurance Fund, for priority groups.

Specifically, in 2026, health insurance participants are patients from near-poor households, elderly people aged 75 and over who are receiving social pension benefits, and will be entitled to 100% coverage of medical examination and treatment costs within the scope of health insurance benefits.

At the same time, increase the rate and level of health insurance payment for drugs, medical equipment, and technical services for health insurance patients, and gradually reduce co-payments for health insurance medical examination and treatment cases.

According to the Institute of Health Strategy and Policy (Ministry of Health), free basic hospital fees help many people have the opportunity to get early treatment, instead of going to the doctor when they are seriously ill. In reality, many ethnic minority and poor people do not go to the doctor because they do not have money to pay, even though they have been issued a health insurance card.

However, according to Trang, to ensure funding for basic free medical examination and treatment, from 2027, the health insurance contribution rate will be increased to 5.1% of basic salary (currently at 4.5%); maintain the budget for contributions, and support health insurance contributions for social policy beneficiaries.

According to the expected roadmap, from 2028 - 2030, the rate and level of health insurance payment for drugs, equipment, and technical services for health insurance participants will continue to increase.

The Ministry of Health estimates that with the roadmap to implement free basic hospital fees and reduce co-payments for patients when examining and treating with health insurance, from 2028 to 2030, people's out-of-pocket spending on health care will be reduced to below 30%. Currently, 40% of health care costs come from people's out-of-pocket, which is a financial barrier for many people in accessing health services.

Also in the 2028 - 2030 period, there will be a pilot program to screen 2 - 3 diseases for free for health insurance participants; payment from the Health Insurance Fund for disease prevention services; and increase health insurance coverage to over 95% of the population.

Controlling service abuse and hospital overload

Regarding solutions to ensure sustainable financial resources for implementing basic free hospitalisation, the Ministry of Health expects that the health insurance premium will continue to increase to 5.4% from 2030. At the same time, pilot supplementary health insurance; diversify health insurance packages for medical examination and treatment and long-term care. After 2030, implement universal health insurance coverage.

According to the estimates of the Institute of Strategy and Health Policy, the total cost that patients pay together is currently about 21.5 trillion VND/year. When implementing basic fee exemption, the additional amount of money needed will be higher than the amount that patients pay together, because when basic hospital fees are exempted, the need for medical examination and treatment will increase.

Therefore, experts from the Institute of Strategy and Health Policy also proposed that, for those participating in health insurance, first of all, basic hospital fees should be exempted for commune-level health services, while improving professional capacity, medical equipment, and expanding the list of drugs at commune levels.

For patients with serious illnesses and high costs, refer to the model that some countries have implemented, that is, regulating a co-payment ceiling. When the co-payment level exceeds the ceiling, financial resources from the budget and health insurance will be paid to the patient, so that the seriously ill patient does not have financial difficulties.

The Institute of Health Strategy and Policy also recommends that, along with implementing basic hospital fee exemption and gradually reducing co-payment levels when examining and treating health insurance, it is necessary to control waste, service abuse and hospital overload.

Source: https://thanhnien.vn/du-kien-tu-2026-thuc-hien-mien-vien-phi-co-ban-cho-nhom-uu-tien-185251201174548784.htm