Towards universal health insurance coverage

Dong Nai currently has more than 4 million people participating in health insurance (HI), accounting for over 91.9% of the province’s population. This rate indicates that residents are becoming increasingly aware of the importance of HI, as well as the practical benefits this social welfare policy provides.

A patient undergoing heart surgery at Dong Nai General Hospital has a large share of the treatment costs covered by the health insurance fund. Photo: Hanh Dung

To meet the target of 95% of the population enrolled in HI by the end of 2025, the province needs to add nearly 197,000 new participants. This endeavor will help move toward the goal of achieving HI coverage for the entire population in the future.

Benefits continue to expand

Nguyen Thi Quy, Deputy Director of the Dong Nai Social Insurance Agency, said the 2024 Health Insurance Law includes multiple new provisions that make medical examination and treatment more convenient for the public. HI cardholders are entitled to 100% benefits when receiving care at their registered primary healthcare facility anywhere in the country, 100% coverage for inpatient treatment at provincial-level hospitals nationwide, and access to high-tech medical services when suffering from severe or life-threatening illnesses. Notably, children under 18 receive financial support for refractive error treatment, serving as an essential and humane improvement in today’s HI policy.

In reality, data from Dong Nai show that each year, many cases receive reimbursements from the health insurance fund, ranging from several hundred million to several billion VND. One patient in Tan Trieu Ward was reimbursed up to 2.8 billion VND, while many others in areas such as Bien Hoa, Dinh Quan, and Cam My also received more than 1 billion VND each for the treatment of severe illnesses or long-term chronic conditions. In the first 11 months of 2025, more than 9.6 million healthcare visits in the province were covered by the health insurance fund, with total payments exceeding 4.6 trillion VND.

Specialist Level II Le Thi Phuong Tram, Deputy Director of Dong Nai General Hospital, stated that as a provincial-level facility providing specialized medical services, the hospital receives more than 3,000 outpatient visits and over 1,100 inpatient admissions every single day. Among these are numerous severe and critical cases, such as pneumonia, sepsis, and multi-organ failure. Many patients require advanced medical procedures, including cardiovascular interventions, joint replacements, and spinal surgeries, each of which involves substantial costs. In many cases, without support from health insurance, a single course of treatment could cost patients several hundred million dong.

Phuong Tram also noted that the current disease landscape is shifting. Non-communicable diseases such as hypertension, diabetes, chronic kidney disease, and cardiovascular conditions are on the rise and increasingly affecting younger individuals. These illnesses are long-term, often lifelong, with monthly expenses for medication and testing running into several million dong. For patients with kidney failure who require dialysis, monthly costs can average around 10 million dong. Thanks to the health insurance fund, patients are largely shielded from long-term financial strain.

At a recent meeting of the Steering Committee on Social Insurance, Health Insurance, and Unemployment Insurance Policies in the province, Le Truong Son, member of the Provincial Party Standing Committee and Vice Chairman of the Dong Nai Provincial People’s Committee, urged departments, sectors, and localities to implement diverse and innovative measures to continue raising the HI participation rate, aiming to achieve HI coverage for the entire population in the coming period.

Ensuring that every resident has a health insurance (HI) card

Recognizing the financial hardships faced by people, particularly ethnic minorities, older individuals, low-income and near-poor households, as well as students, the province of Dong Nai has allocated significant budget resources to subsidize health insurance premiums, aiming to ensure that every resident holds a health insurance card.

Deputy Director of the provincial Social Insurance Agency Nguyen Thi Quy said that under resolutions of the Dong Nai Provincial People’s Council, the province provided subsidies for more than 139,500 HI cards during the 2022–2025 period. In the former Binh Phuoc area alone, more than 180,800 people received HI support during 2024–2025, including near-poor households, agricultural, forestry, and fishery households with average incomes, and ethnic minorities living in Zone II and Zone III communes, as well as in especially disadvantaged hamlets in ethnic minority and mountainous regions. These figures reflect the province’s strong commitment to social welfare and the right to healthcare.

Regarding contribution rates, Deputy Director of the provincial Social Insurance Agency, Nguyen Thi Quy, noted that under household HI, premiums decrease for the second, third, and fourth members, and from the fifth member onward, the contribution is only 40% of the first member’s rate. This policy helps large families reduce expenses while ensuring full benefits. For students, the State subsidizes at least 50% of the premium, meaning they pay just over 634,000 VND per year instead of more than 1.2 million VND.

Moreover, with the implementation of nationwide and province-wide referral rules for inpatient treatment, HI benefits have become even more accessible. Regardless of their registered primary facility, patients receive 100% coverage for inpatient treatment at provincial hospitals such as Dong Nai General Hospital or Thong Nhat General Hospital.

Clearly, HI is not only a “lifeline” in times of illness but also a deeply humane mechanism of community sharing. Healthy individuals who participate today help others overcome illness; when they themselves face hardship, the HI fund becomes their reliable source of support.

By Hanh Dung – Translated by Quynh Nhu, Minho