Circular No. 98/2025/TT-BQP guiding the implementation of certain provisions of Decree No. 188/2025/NĐ-CP dated July 1, 2025 of the Government detailing and guiding the implementation of certain articles of the Health Insurance Law for subjects under the management of the Ministry of National Defense.

CIRCULAR

Guidelines for Implementing Certain Provisions of Decree No. 188/2025/NĐ-CP dated July 1, 2025 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law for subjects under the management of the Ministry of National Defense

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Pursuant to the Health Insurance Law dated November 14, 2008; the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated June 13, 2014; and the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated November 27, 2024;

Pursuant to Decree No. 188/2025/NĐ-CP dated July 1, 2025 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law;

Pursuant to Decree No. 70/2015/NĐ-CP dated September 1, 2015 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law for the People's Army, the People's Public Security Force, and personnel engaged in confidential work; and Decree No. 74/2025/NĐ-CP dated March 31, 2025 amending and supplementing certain provisions of Decree No. 70/2015/NĐ-CP dated September 1, 2015 of the Government;

Pursuant to Decree No. 01/2022/NĐ-CP dated November 30, 2022 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of National Defense; and Decree No. 03/2025/NĐ-CP dated February 28, 2025 amending and supplementing certain provisions of Decree No. 01/2022/NĐ-CP dated November 30, 2022 of the Government;

In accordance with the proposal of the Director of the General Logistics Department - Technical Service;

The Minister of National Defense promulgates this Circular to guide the implementation of certain provisions of Decree No. 188/2025/NĐ-CP dated July 1, 2025 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law for subjects under the management of the Ministry of National Defense;

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular stipulates on:

1. Contribution levels, support levels, contribution methods, and responsibility for health insurance contributions; determining the amount contributed and supported for certain subjects when the State adjusts health insurance contribution levels or basic wage levels.

2. Health insurance cards; issuance, reissuance, replacement, recovery, temporary retention of health insurance cards; validity period of health insurance cards. Benefit levels and scope of health insurance coverage; registration for initial medical examination and treatment under health insurance; transfer of patients between healthcare facilities.

3. Methods for settling costs of medical examination and treatment under health insurance; payment and settlement of costs of medical examination and treatment under health insurance; management and use of the health insurance fund.

Article 2. Applicability

1. Group contributing to health insurance by employees and employers

a) Military personnel and civil servants in the military; personnel engaged in other work in confidential organizations under the General Confidential Service Department;

b) Civil servants in the military;

c) Employees working under indefinite-term labor contracts or definite-term labor contracts with a duration of at least one month in agencies and units under the Ministry of National Defense;

d) Young volunteers as prescribed in Decision No. 1529/QĐ-TTg dated September 15, 2021 of the Prime Minister approving the content of the Project "Strengthening Young Volunteers Working in Economic Zones - National Defense" until 2030.

2. Group contributing to health insurance by social insurance agencies

Employees under the management of the Ministry of National Defense who have ceased work and are receiving sickness benefits due to long-term illness or who have ceased work and are receiving sickness benefits for fourteen days or more in a month according to the law on social insurance; employees who have ceased work and are receiving maternity leave benefits for fourteen days or more in a month according to the law on social insurance.

3. Group contributing to health insurance by the state budget

a) Personnel engaged in confidential work receiving salaries equivalent to those of military personnel working in confidential organizations under various ministries, sectors, and localities except the Ministry of National Defense and the Ministry of Public Security;

b) Full-time militia;

c) Relatives of the subjects specified in points a and b of Clause 1, and points a and b of Clause 3, Article 2 of Decree No. 70/2015/NĐ-CP dated September 1, 2015 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law for the People's Army, the People's Public Security Force, and personnel engaged in confidential work, as amended and supplemented in Clause 2, Article 1 of Decree No. 74/2025/NĐ-CP dated March 31, 2025 of the Government, including subjects specified in points a, b, and c of Clause 5 of this Article who have not yet joined health insurance;

d) Students training in military academies at the college and university level in the concentrated system under the decision of the Prime Minister and relevant laws before January 1, 2025, who are receiving living expenses from the state budget and have not yet joined health insurance shall join health insurance under the group funded by the state budget as stipulated in Clause 3, Article 12 of the Health Insurance Law.

4. Group receiving state budget support for health insurance contributions

Civilian students and students in military academies and confidential institutions.

5. Group contributing to health insurance by employers

Relatives of the subjects specified in point a of Clause 1 of this Article who do not fall within the categories of subjects joining health insurance as stipulated in points a, b, c, d, đ, e, g, and h of Clause 1, Clause 2, and Clause 3 of Article 12 of the Health Insurance Law, including:

a) Biological father, biological mother, or legally recognized foster parent; biological father, biological mother, or legally recognized foster parent of spouse;

b) Spouse;

c) Biological child or legally recognized foster child aged over six but under eighteen years old; biological child or legally recognized foster child aged eighteen or older if still continuing secondary education.

6. Healthcare facilities under the Ministry of National Defense; related agencies, units, and individuals.

Article 3. Subjects not subject to application

1. The subjects specified in Article 2 of this Circular during their time living, studying, or working temporarily abroad.

2. Relatives of the subjects specified in points b, c, and d of Clause 1, Clause 2, points a, b, and d of Clause 3, and Clause 4 of Article 2 of this Circular.

Chapter II

CONTRIBUTION LEVELS, CONTRIBUTION SUPPORT LEVELS, CONTRIBUTION OBLIGATIONS, AND CONTRIBUTION METHODS FOR HEALTH INSURANCE

Article 4. Contribution levels, contribution support levels, and contribution obligations for health insurance

1. For the subjects specified in Clause 1 of Article 2 of this Circular

a) The monthly contribution rate is 4.5% of the monthly salary used as the basis for compulsory social insurance contributions, with the employer contributing two-thirds and the employee contributing one-third;

b) In cases where employees are temporarily detained, imprisoned, suspended from work, or suspended from office but have not been disciplined, the monthly contribution rate is 4.5% of 50% of the monthly salary used as the basis for compulsory social insurance contributions of the employee in the month immediately preceding detention, arrest, or suspension, according to the law, with the employer contributing two-thirds and the employee contributing one-third. If the competent authority concludes that there has been no violation of the law, the employer and employee must make up the health insurance contributions based on the salary recovered;

c) The funding source for the employer's contributions shall be implemented in accordance with Clause 9 of Article 7 of Decree No. 188/2025/NĐ-CP.

2. For the subjects specified in Clause 2 of Article 2 of this Circular

The contribution rate is 4.5% of the base salary, funded by the Social Insurance Fund.

3. For the subjects specified in points c and d of Clause 3 of Article 2 of this Circular

The monthly contribution rate is 4.5% of the base salary, guaranteed by the State budget.

4. For the subjects specified in Clause 4 of Article 2 of this Circular

The monthly contribution rate is 4.5% of the base salary, self-funded by the subject and partially supported by the State budget according to Clause 5 of this Article.

5. The level of support from the State budget for the subjects specified in Clause 4 of Article 2 of this Circular is as follows:

a) Full support of 100% of the health insurance contribution rate for students and pupils belonging to near-poor households residing in poor communes as decided by the Prime Minister and other competent authorities;

b) Minimum support of 70% of the health insurance contribution rate for students and pupils belonging to near-poor households and ethnic minorities living in communes no longer classified as economically and socially difficult areas within 36 months from the date such communes are no longer classified as economically and socially difficult areas;

c) Minimum support of 50% of the health insurance contribution rate for other students and pupils; the remaining portion of the contribution rate is self-funded by the students and pupils;

d) In cases where students and pupils belong to multiple categories eligible for State budget support, they may choose to participate under the category with the highest support level.

6. For the subjects specified in Clause 5 of Article 2 of this Circular

a) The monthly contribution rate is 4.5% of the base salary;

b) The funding source for the employer's contributions shall be implemented in accordance with Clause 9 of Article 7 of Decree No. 188/2025/NĐ-CP.

Article 5. Methods of Paying Health Insurance Contributions

1. For the subjects specified in Clause 1 of Article 2 of this Circular

Monthly, the unit directly managing the subjects shall pay health insurance contributions for employees and deduct the health insurance contributions from the employees' salaries at the contribution rate specified in point a of Clause 1 of Article 4 of this Circular, and submit them together to the superior unit directly subordinate to the Ministry of National Defense to submit to the Military Social Insurance Fund no later than the last day of the following month.

2. For the subjects specified in Clause 2 of Article 2 of this Circular

Annually, the Military Social Insurance Fund shall consolidate the health insurance contribution amounts for this group of subjects and send them to the Vietnam Social Insurance Fund to ensure the funding for health insurance contributions.

3. For the subjects specified in points c and d of Clause 3 of Article 2 of this Circular

Quarterly, units subordinate to the Ministry of National Defense shall pay 25% of the annual health insurance revenue budget to the Military Social Insurance Fund no later than the last day of the first month of the next quarter.

Based on the number of issued cards, the amount of health insurance revenue due, units subordinate to the Ministry of National Defense shall complete the payment of health insurance contributions for these subjects to the Military Social Insurance Fund no later than December 15th each year.

4. For the subjects specified in points a and b of Clause 3 of Article 2 of this Circular

Quarterly, agencies and units under ministries, sectors, and localities managing the subjects shall pay health insurance contributions no later than the last day of the first month of the next quarter to the social insurance agency issuing the health insurance card.

5. For the subjects specified in Clause 4 of Article 2 of this Circular

Annually, the unit directly managing students and pupils shall collect the health insurance contribution portion of responsibility from students and pupils and submit it to the superior unit directly subordinate to the Ministry of National Defense to submit to the Military Social Insurance Fund within 30 days from the start of the academic year (for first-year students and pupils) or no later than the last day of the first month of the fiscal year (for other students and pupils).

In cases where first-year students and pupils of a course still have valid grade 12 health insurance cards: Collect contributions from students and pupils from the month after the grade 12 health insurance card expires until December 31st.

In cases where final-year students and pupils: Collect contributions from students and pupils from January 1st to the end of the academic year.

6. For the subjects specified in Clause 5 of Article 2 of this Circular

Monthly, the employer shall pay health insurance contributions for this subject along with the health insurance contributions for employees as stipulated in Clause 9 of Article 7 of Decree No. 188/2025/NĐ-CP.

Article 6. Determination of the amount to be paid and supported for certain subjects when the State adjusts the health insurance contribution rate and the basic wage level

1. For subjects whose health insurance contributions are fully covered by the State budget at 100%

a) The monthly amount of the State budget's payment and support is determined based on the health insurance contribution rate multiplied by the basic wage level;

b) When the State adjusts the health insurance contribution rate and the basic wage level, the amount of the State budget's payment and support will be adjusted from the date the new health insurance contribution rate and basic wage level take effect.

2. For subjects whose health insurance contributions are partially supported by the State budget

a) The monthly amount of the participant's health insurance contribution and the State budget's support is determined based on the health insurance contribution rate multiplied by the basic wage level at the time the participant joins the health insurance program;

b) When the State adjusts the health insurance contribution rate and the basic wage level, students and the State budget will not make additional payments or refund the difference due to the adjustment of the health insurance contribution rate and the basic wage level for the remaining period during which the students have already contributed to the health insurance program.

3. For subjects who join the health insurance program within a month, the health insurance contribution amount is determined monthly starting from the month they contribute to the health insurance program.

Chapter III

HEALTH INSURANCE CARD

Article 7. Health Insurance Card

1. The health insurance card for subjects specified in Clause 1, Points c and d of Clause 3, Clause 4, and Clause 5 of Article 2 of this Circular shall be implemented according to the provisions of Articles 9, 10, 11, 12, and 13 of Decree No. 188/2025/NĐ-CP dated July 1, 2025, issued by the Government detailing and guiding the implementation of certain articles of the Health Insurance Law.

In cases where a person belongs to multiple health insurance categories, the health insurance card will be issued based on the first category that the person contributes to according to the order stipulated in Article 12 of the Health Insurance Law amended and supplemented in Clause 10 of Article 1 of the Law Amending and Supplementing Certain Provisions of the Health Insurance Law; the benefit level recorded on the health insurance card is the highest benefit level among the categories; for subjects specified in Points c and d of Clause 1 of Article 2 of this Circular with one or more labor contracts, the health insurance card will be issued based on the contract serving as the basis for mandatory social insurance participation.

2. The health insurance card issued by the Military Social Insurance includes basic information:

a) Health insurance number;

b) Personal information of the health insurance participant, including: Full name; gender; date, month, year of birth;

c) Date the health insurance card becomes valid for use;

d) Registration location for initial medical examination and treatment under health insurance;

đ) Information about the health insurance benefit level according to the health insurance category;

e) Date of continuous health insurance participation for five years or more for subjects required to co-pay for medical examination and treatment costs;

g) Specifically, for paper health insurance cards, additional information includes: Printed title, scanned signature and rank, full name of the Director of the Military Social Insurance.

3. The electronic health insurance card is presented in an electronic data format established by the Military Social Insurance using electronic means, containing information as specified in Points a, b, c, d, đ, and e of Clause 2 of this Article.

4. Health insurance card information is integrated for lookup by health insurance number, citizen identification number/personal identification number of the health insurance participant.

5. Management, recovery, temporary suspension of the health insurance card's usage value

a) The health insurance card of subjects specified in Article 2 of this Circular will be recovered or temporarily suspended according to the provisions of Article 12 of Decree No. 188/2025/NĐ-CP. Medical examination and treatment facilities under the Ministry of National Defense are responsible for temporarily holding the health insurance card in cases where others use it for medical examination and treatment under health insurance and reporting to the unit and the Military Social Insurance for handling according to the law.

When recovering or temporarily suspending the health insurance card's usage value, the Military Social Insurance will notify the management unit to inform the health insurance participant.

b) The management units of subjects specified in Article 2 of this Circular are responsible for receiving and transferring the health insurance card to individuals and relatives according to current regulations.

Subjects specified in Clause 1 and Point d of Clause 3 of Article 2 of this Circular manage their own health insurance cards, and must report to unit command upon medical examination and treatment according to current regulations.

6. Subjects who are relatives of personnel engaged in other work in confidential organizations as defined by the Confidentiality Law of various Ministries, sectors, and localities except the Ministry of National Defense, and relatives of subjects specified in Point a of Clause 3 of Article 2 of this Circular; subjects specified in Points a and b of Clause 3 of Article 2 of this Circular shall be issued health insurance cards by the Social Insurance of provinces and centrally-administered cities.

Article 8. Duration of Use of Health Insurance Card

Implemented according to the provisions of Article 13 of Decree No. 188/2025/NĐ-CP, specific cases are specified as follows:

1. For subjects listed annually, the value of the health insurance card is calculated from January 1st; for subjects added during the year, the value is calculated from the date of health insurance payment as prescribed by the competent authority.

2. In the case of dependents who are biological or legally adopted children aged over six but under eighteen years old, and those aged eighteen or older still continuing their secondary education, the duration of use of the health insurance card issued by the Military Social Insurance shall be as follows:

a) Dependents aged seven years or older, the value of the health insurance card is calculated from October 1st of that year if born before September 30th; if born after September 30th, the health insurance card is valid from the first day of the month following the month of birth.

Example 1: Nguyen Van Cuong, born on March 5, 2020, is the biological child of Lieutenant Nguyen Van A, Assistant Propaganda Officer, Political Department, Division B, Military Region K; Cuong will be issued a health insurance card with validity starting from October 1, 2026 (when he turns 72 months old).

Example 2: In the case of Nguyen Van Cuong in Example 1, born on October 5, 2020; Cuong will be issued a health insurance card with validity starting from November 1, 2026 (when he turns 72 months old).

b) For dependents who are students in grade twelve, the health insurance card is valid from January 1st to September 30th of the year they are in grade twelve.

3. For dependents of non-commissioned officers and soldiers during their service period from the date of enlistment to the last day of the month of discharge; in cases where they complete their service obligation and are sent for training or have their service period extended, the validity of the card continues from the expiration date of the previous card until the end of the training period or extension.

Example 1: Nguyen Van Tam enlisted on February 14, 2025, and completed his service obligation on January 31, 2027; the health insurance card of Tam's dependent was valid from February 14, 2025, to January 31, 2027.

Example 2: In the case of Nguyen Van Tam in Example 1, Tam completed his service obligation on January 31, 2027, and was sent for reserve officer training from February 1, 2027. The training unit requested issuance of a health insurance card for Tam's dependent with validity from February 1, 2027, to the end of the reserve officer training period.

4. For dependents of military students and students at special schools receiving living expenses, the health insurance card is valid from the date of enrollment to December 31st of the graduation year.

Article 9. Issuance and Adjustment of Information on Health Insurance Cards

Issuance of health insurance cards (including initial issuance and reissuance) and adjustment of information on health insurance cards are carried out as follows:

1. The Military Social Insurance issues health insurance cards to subjects specified in Clause 1, Clause 2, Points c and d of Clause 3, Clause 4, and Clause 5 of Article 2 of this Circular, either electronically or on paper; the procedures, declarations, responsibilities, and time limits for issuing health insurance cards are implemented according to Articles 7 and 8 of Decree No. 70/2015/NĐ-CP amended and supplemented by Clauses 6 and 7 of Article 1 of Decree No. 74/2025/NĐ-CP. In the case of issuing paper health insurance cards, the cards are delivered to the insured through the units.

2. The heads of battalion-level units and equivalent units are responsible for directing personnel departments, military affairs offices, and labor organizations:

To guide military personnel in filling out the Application Form for Participation and Adjustment of Health Insurance Information according to Model No. 01/BHYT-QĐ and Model No. 02/BHYT-QĐ attached as an appendix to this Circular; to prepare the List of Participants in Health Insurance and the request for issuance, reissuance, and replacement of health insurance cards; the List of Reissued and Replaced Health Insurance Cards according to Model No. 04/BHYT-QĐ and Model No. 05/BHYT-QĐ attached as an appendix to this Circular, which are submitted via software provided by the Military Social Insurance to division-level units and above.

3. The heads of division-level units and equivalent units are responsible for directing personnel departments, military affairs offices, and labor organizations:

a) To prepare the List of Participants in Health Insurance; the request for issuance, reissuance, and replacement of health insurance cards; the List of Issued, Reissued, and Replaced Health Insurance Cards according to Models No. 03, 04, 05, and 06/BHYT-QĐ attached as an appendix to this Circular (available on software provided by the Military Social Insurance) and submit them to the Military Social Insurance. In cases where units do not have military network connections, requests for issuance, reissuance, and replacement of health insurance cards are processed according to current regulations;

b) In cases where the health insurance card issued by the Military Social Insurance has expired but the insured person still falls within the category eligible for the next year's card, the unit (division-level and equivalent) prepares a request for extending the participation period in health insurance according to Model No. III attached as an appendix to Circular No. 63/2025/TT-BQP.

4. Issuance of health insurance cards for new recruits' dependents is carried out as follows: Before enlistment, the People's Militia Headquarters at the commune level and equivalent units guide citizens called up for enlistment to fill out the Application Form for Participation in Health Insurance, with confirmation from the People's Committee at the commune level or equivalent, and hand over the form along with the military service file to the receiving unit. Units tasked with training new recruits implement the procedures stipulated in Clauses 1, 2, and 3 of this Article.

5. In cases where the health insurance card of a dependent is damaged, lost, or the information on the card does not match the identification (citizen identity card), relevant agencies and units instruct dependents to contact the Military Social Insurance directly to obtain a replacement or reissued health insurance card.

Chapter IV

LEVEL OF BENEFITS AND SCOPE OF HEALTH INSURANCE COVERAGE; REGISTRATION FOR INITIAL HEALTH INSURANCE MEDICAL EXAMINATION AND TREATMENT; TRANSFER OF PATIENTS BETWEEN HEALTH INSURANCE MEDICAL FACILITIES;

Article 10. Level of Health Insurance Benefits

1. Persons participating in health insurance who fall under the categories specified in Clause 1, Clause 2, Point c and d Clause 3, Clause 4 and Clause 5 of Article 2 of this Circular when seeking medical examination and treatment as prescribed in Articles 26 and 27 of the Health Insurance Law shall be reimbursed for medical examination and treatment costs within the scope of benefits at the following levels:

a) 100% of the costs of medical examination and treatment within the scope prescribed in Article 10 of Decree No. 70/2015/ND-CP amended and supplemented in Clause 10 of Article 1 of Decree No. 74/2025/ND-CP, and not applying the percentage or level of reimbursement prescribed in Point c and d Clause 2 of Article 21 of the Health Insurance Law to the categories specified in Points a and b Clause 3 of Article 2 of this Circular;

b) 80% of the costs of medical examination and treatment within the scope of benefits for the categories specified in Article 2 of this Circular, except for the categories specified in Point a of this sub-clause.

2. 100% of the costs of medical examination and treatment in cases where the cost for one-time medical examination and treatment is lower than 15% of the basic wage.

3. The level of health insurance benefits for persons with five consecutive years or more of health insurance participation shall be implemented according to the provisions of Article 18 of Decree No. 188/2025/ND-CP.

4. In cases where the level of health insurance benefits of a person participating in health insurance falls under multiple situations prescribed in Article 22 of the Health Insurance Law or changes in the level of health insurance benefits, it shall be implemented according to the provisions of Article 21 of Decree No. 188/2025/ND-CP.

Article 11. Medical Examination and Treatment under Health Insurance in Certain Cases

1. Persons falling under Article 2 of this Circular when seeking medical examination and treatment must present information about their health insurance card and personal identification documents according to one of the forms prescribed in Clause 1 of Article 37 of Decree No. 188/2025/ND-CP.

2. Health examination and treatment facilities under health insurance shall conduct inquiries on the health insurance card information of the persons specified in Article 2 of this Circular in the National Database on Insurance and the Ministry of Defense's Health Insurance Database according to the provisions of Clause 2 of Article 8 of Circular No. 63/2025/TT-BQP.

3. In cases where a patient participating in health insurance cannot present information about their health insurance card or is currently waiting for issuance, reissuance, or replacement of the health insurance card, military medical units, agency healthcare services, and health examination and treatment facilities have the responsibility to immediately notify the Social Security Agency to provide the health insurance code or issue the health insurance card. Health examination and treatment facilities have the responsibility to accept medical examination and treatment and ensure full scope of rights and health insurance benefit levels for health insurance participants; to compile and settle medical examination and treatment costs according to the guidance of the Military Social Security Agency.

4. Health examination and treatment facilities may not stipulate additional procedures for health insurance medical examination and treatment beyond those prescribed in Clause 1 of this Article.

Article 12. Registration for Health Insurance Medical Examination and Treatment; Transfer of Patients Between Health Insurance Medical Examination and Treatment Facilities

1. Persons participating in health insurance from all categories may choose one of the health examination and treatment facilities under primary, basic, and specialized levels near their place of residence, work, study, and suitable for the capacity of the facility to register for initial health insurance medical examination and treatment, specifically as follows:

a) For the categories specified in Point a Clause 1, Point c and d Clause 3 and Clause 5 of Article 2 of this Circular, they shall implement according to the provisions of Article 11 of Circular No. 21/2025/TT-BQP dated April 14, 2025, issued by the Minister of Defense regarding the classification of technical expertise levels; quality assessment and certification of health examination and treatment facilities; registration and transfer of patients between health examination and treatment facilities under the Ministry of Defense;

b) For the categories specified in Points b, c and d Clause 1, Points a and b Clause 3, Clause 4 of Article 2 of this Circular, they shall implement according to the provisions of Article 7 of Circular No. 01/2025/TT-BYT dated January 1, 2025, issued by the Minister of Health detailing and guiding the implementation of certain articles of the Health Insurance Law.

2. The transfer of patients undergoing inpatient treatment or emergency care to health examination and treatment facilities managed by the Ministry of Defense shall be carried out as follows:

a) For the categories specified in Points a and b Clause 3 of Article 2 of this Circular, they shall implement according to the provisions of Article 12 of Circular No. 21/2025/TT-BQP;

b) For the categories specified in Article 2 of this Circular, they shall implement according to the provisions of Articles 9 and 10 of Circular No. 01/2025/TT-BYT, except for the categories specified in Point a of this sub-clause.

Chapter V

PAYMENT AND SETTLEMENT OF HEALTH INSURANCE MEDICAL EXAMINATION AND TREATMENT COSTS

Article 13. Method of payment for medical examination and treatment costs under health insurance between social insurance agencies and medical establishments

1. Payment shall be made according to service prices, fixed rates, diagnostic groups, and medical examination and treatment costs for certain cases as prescribed in Articles 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, and 53 of Decree No. 188/2025/NĐ-CP and Article 18 of Decree No. 70/2015/NĐ-CP amended and supplemented by Clause 14 of Article 1 of Decree No. 74/2025/NĐ-CP, based on different categories of subjects.

2. Transportation cost payments shall be implemented as prescribed in Article 14 of Decree No. 188/2025/NĐ-CP.

Article 14. Direct payment of medical examination and treatment costs under health insurance between social insurance agencies and health insurance participants

1. Direct payment of medical examination and treatment costs under health insurance for subjects specified in Clause 1, Points c and d of Clause 3, Clause 4, and Clause 5 of Article 2 of this Circular shall be carried out as prescribed in Articles 54, 55, 56, 57, 58, 59, and 60 of Decree No. 188/2025/NĐ-CP.

2. The direct payment costs shall be paid through bank transfers to the account number provided in the direct payment request document or the account number of the authorized person on the power of attorney.

Chapter VI

MANAGEMENT, COLLECTION, AND EXPENDITURE OF HEALTH INSURANCE FUNDS

Article 15. Management and use of health insurance funds

1. Collection and submission of health insurance premiums for subjects specified in Clause 1, Points c and d of Clause 3, Clause 4, and Clause 5 of Article 2 of this Circular shall be carried out in accordance with the Government's regulations on financial mechanisms, social insurance, unemployment insurance, health insurance, organizational and operational expenses for social insurance, unemployment insurance, and health insurance.

2. Management and utilization of medical examination and treatment funds for primary healthcare services for subjects specified in Clause 1, Point d of Clause 3, and Clause 4 of Article 2 of this Circular shall be carried out as prescribed in Articles 62 and 63 of Decree No. 188/2025/NĐ-CP.

3. Organizational and operational expenses for health insurance shall be carried out as prescribed in Article 61 of Decree No. 188/2025/NĐ-CP.

Article 16. Preparation of budget estimates for revenue and expenditure, notification of estimated expenditure, and settlement of revenue and expenditure of health insurance funds

Preparation of budget estimates for revenue and expenditure, notification of estimated expenditure, and settlement of revenue and expenditure of health insurance funds for subjects specified in Clause 1, Points c and d of Clause 3, Clause 4, and Clause 5 of Article 2 of this Circular shall be carried out as prescribed in Article 65 of Decree No. 188/2025/NĐ-CP and the Government's regulations on financial mechanisms, social insurance, unemployment insurance, health insurance, organizational and operational expenses for social insurance, unemployment insurance, and health insurance.

Chapter VII

RESPONSIBILITIES OF THE AGENCIES AND UNITS

Article 17. Responsibilities of the General Staff Department

1. Direct the Cryptographic Bureau to coordinate with the 86th Corps Command and the Telecommunications and Information Service Branch to ensure information security when connecting data with the Ministry of Health, national population database, and national insurance database; ensure security during electronic transactions related to health insurance; advise on upgrading and supplementing infrastructure and cybersecurity, implement centralized system monitoring in accordance with the Ministry of Defense's regulations and the Ministry of Science and Technology's guidelines.

2. Direct the Military Affairs Department to coordinate with relevant agencies to advise and propose health insurance policies for subjects managed by the Ministry of Defense; direct agencies, units, and the entire military's military affairs department to disseminate and implement health insurance policies, carry out declarations, and compile lists to request competent authorities to issue health insurance cards for subjects within their management scope and relatives as prescribed.

Article 18. Responsibilities of the Political General Department

1. Direct the Personnel Bureau to coordinate with relevant agencies, advise and propose health insurance policies for subjects under the management of the Ministry of National Defense; direct agencies, units, and the entire military personnel bureau to disseminate and implement health insurance policies, carry out declarations, compile lists to request competent authorities to issue health insurance cards for subjects within their jurisdiction and relatives as prescribed.

2. Direct the Policy and Social Affairs Bureau (Military Social Insurance) to coordinate with relevant agencies to study, advise, and propose health insurance policies for subjects under the management of the Ministry of National Defense and implement health insurance for such subjects, specifically as follows:

a) Implement the contents stipulated in Clause 3, Article 18 of Circular No. 63/2025/TT-BQP; establish a management code for social insurance;

b) Compare data from health insurance cards and settle costs for medical examinations and treatments covered by health insurance for subjects specified in Clauses 1, point c and d of Clause 3, Clause 4, and Clause 5 of Article 2 of this Circular;

c) Apply information technology to manage and ensure the security of all health insurance activities within the Ministry of National Defense; comply with regulations on protecting state secrets and those of the Ministry of National Defense, laws on electronic transactions, storage; manage health insurance card data; manage and audit medical examination and treatment costs covered by health insurance based on electronic data, ensuring connectivity and data sharing capabilities with the Vietnam Social Security and other information systems suitable for the characteristics of the Military;

d) Direct and guide healthcare facilities to submit electronic data in accordance with the Ministry of Health and Vietnam Social Security regulations; extract and transfer electronic data according to Articles 6 and 7 of Circular No. 48/2017/TT-BYT dated December 28, 2017, issued by the Minister of Health regarding the extraction and transfer of electronic data in managing and settling costs for medical examinations and treatments covered by health insurance.

Article 19. Responsibilities of the Logistics and Technical General Department

Direct the Medical Service Bureau to implement medical examinations and treatments covered by health insurance for subjects under the management of the Ministry of National Defense, specifically as follows:

1. Study, advise, and propose policies, mechanisms, and methods for organizing and implementing medical examinations and treatments covered by health insurance for subjects specified in Article 2 of this Circular. Coordinate with related agencies and units to publicize health insurance policies within the Ministry of National Defense.

2. Determine the actual capacity of hospital beds at healthcare facilities under the Ministry of National Defense as a basis for developing annual professional plans and settling and finalizing costs for medical examinations and treatments covered by health insurance for these facilities.

3. Take the lead and coordinate with relevant agencies to inspect the implementation of health insurance policies and mechanisms at agencies, units, and healthcare facilities under the Ministry of National Defense.

Article 20. Responsibilities of the Finance Bureau/Ministry of National Defense

1. Take the lead and coordinate with the Medical Service Bureau/Logistics and Technical General Department and functional agencies to advise and propose financial mechanisms and policies for health insurance suitable for the organizational structure and operations of the Military.

2. Guide agencies and units to prepare budgets, settle, and finalize the national budget contributions for health insurance for subjects (the portion of responsibility borne by the Ministry of National Defense) in accordance with current state and Ministry of National Defense regulations.

3. Annually, compile the national budget contributions for health insurance for subjects (the portion of responsibility borne by the Ministry of National Defense), report to the Ministry of National Defense to request the state to allocate the budget for the Ministry of National Defense.

Article 21. Responsibilities of the General Department 86/Ministry of National Defense, Telecommunications Corps

1. Ensuring connection standards, transmission lines, infrastructure, information security, and connecting the Ministry of National Defense's public service portal with the Ministry of Health, the national population database, and the national insurance database; ensuring information security at the appropriate level for the administrative procedure information system of Military Medicine, electronic transactions in issuing, managing health insurance cards, and medical examinations and treatments under Circular No. 85/2016/ND-CP dated July 1, 2016 on ensuring the security of information systems at different levels.

2. Upgrading and supplementing infrastructure and measures to ensure network information security level 3 according to Circular No. 85/2016/ND-CP to meet requirements for infrastructure and network security and implementing centralized monitoring of information system security in accordance with regulations of the Ministry of National Defense and guidelines of the Ministry of Science and Technology.

Article 22. Responsibilities of agencies and units directly subordinate to the Ministry of National Defense

1. Promoting and disseminating policies and laws on health insurance.

2. Implementing regulations on procedures and formalities for issuance (including issuance, reissuance) and adjustment of health insurance card information. Annually, units at brigade level and above shall guide the subjects specified in Article 2 of this Circular to fill out the Application Form for Providing and Changing Information on Social Insurance, Health Insurance Participants, ensuring accuracy in accordance with the prescribed contents, and bear legal responsibility for the list of health insurance card issuance requests from their units and retain the application forms of the subjects at their units. Exploiting and sharing data and information on social insurance and health insurance participants with relevant national databases and specialized databases in accordance with legal provisions and regulations of the Ministry of National Defense.

3. The heads of units directly subordinate to the Ministry of National Defense are responsible for directing subordinate agencies:

a) Closely coordinating with related agencies to ensure full rights to the scope and level of health insurance benefits for the subjects specified in Article 2 of this Circular;

b) Inspecting and guiding the use, payment, and settlement of initial healthcare costs and examination and treatment fees at healthcare facilities under their management in accordance with legal provisions on health insurance;

c) Inspecting and reviewing examinations and treatments for subjects not managed by the Ministry of National Defense to ensure security and safety and not affect unit tasks.

4. Cooperating with General Department 86 and Telecommunications Corps to ensure connection standards, interoperability, and data sharing for health insurance examinations and treatments with the information system and health insurance claims adjudication system of the Military Social Security Fund in accordance with regulations of the Minister of Health and the Minister of National Defense.

Article 23. Responsibilities of health insurance examination and treatment facilities

1. Implementing the provisions of Article 43 of the Health Insurance Law and other responsibilities stipulated by laws on medical examinations and treatments.

2. Adhering to legal provisions on medical examinations and treatments, professional guidance from the Ministry of Health, and procurement and bidding regulations to ensure the supply of medicines, chemicals, medical equipment, and medical technical services.

3. Properly implementing legal provisions on input data standards, output data standards, electronic data extraction and transfer, digital conversion, and electronic transactions in the medical field. Applying information technology and digital transformation in implementing health insurance in accordance with legal provisions; ensuring the maintenance of connection standards and interoperability of electronic data for health insurance examinations and treatments verified with the information system and health insurance claims adjudication system of the Military Social Security Fund as prescribed.

4. Publicizing the results of technical expertise grading approved by competent authorities along with points on the facility’s website and at patient reception areas.

5. Sending electronic data on medical examinations and treatments immediately after the end of outpatient visits or inpatient stays. Signing off on monthly or quarterly summary expense reports for health insurance participants as prescribed by the Minister of Health, verifying electronic data in accordance with legal provisions to serve management and cost reimbursement; bearing legal responsibility for the accuracy of the summary expense report submitted for reimbursement compared to the detailed expense report of the health insurance participant.

6. Ensuring compliance with legal provisions on health insurance, medical examinations and treatments, and health insurance examination and treatment contracts for health insurance activities.

7. Providing medical records and related documents concerning health insurance examinations and treatments and cost reimbursements for the subjects specified in Article 2 of this Circular upon request from the Military Social Security Fund and competent state authorities.

8. Summarizing, paying, and settling health insurance examination and treatment costs for the subjects specified in Article 2 of this Circular as prescribed; promptly reviewing and issuing professional procedures and guidelines for health insurance examinations and treatments, measures to prevent abuse and fraud of health insurance funds within their authority; proactively identifying, reviewing, and verifying increased health insurance examination and treatment costs at their facilities based on recommendations and warnings from the Military Social Security Fund in accordance with legal provisions.

9. Immediately notifying the Military Social Security Fund to provide health insurance numbers or issue health insurance cards when health insurance participants go for medical examinations and treatments without presenting health insurance card information or are awaiting issuance, reissuance, or replacement of health insurance cards.

Article 24. Responsibilities of individuals implementing the health insurance policy

1. Fill out forms within their responsibility as prescribed and bear legal responsibility for the accuracy of the information provided.

2. Upon receiving a health insurance card, they must check and verify the contents recorded on the health insurance card; if incorrect, return the health insurance card to the unit for transfer to the Military Social Insurance Fund.

3. Fulfill all obligations of a health insurance participant; have the right to request the social insurance organization, health care facilities covered by health insurance, and related agencies to explain and provide information about the health insurance regime; have the right to lodge complaints and denunciations against violations of health insurance laws.

4. Safeguard and manage the health insurance card; in case the health insurance card is lost, torn, or damaged, fill out the Health Insurance Participation and Information Adjustment Form according to Form No. 01/BHYT-QĐ and submit it to the directly managing agency.

Chapter VIII

IMPLEMENTING PROVISIONS

Article 25. Effective Date

1. This Circular takes effect from October 16, 2025, except for the provisions of Clause 2 and Clause 3 of this Article.

2. Articles from Article 1 to Article 6, Clauses 2, 3, 4, Point b Clause 5 and Clause 6 of Article 7, Article 9, Clauses 1, 2 and 3 of Article 10, Clauses 2 and 3 of Article 11, Article 12, Clause 2 of Article 13, Article 14, Clauses 1 and 3 of Article 15, from Article 17 to Article 26 of this Circular take effect from July 1, 2025.

3. Clause 1 and Point a Clause 5 of Article 7, Article 8, Clause 4 of Article 10, Clause 1 and 4 of Article 11, Clause 1 of Article 13, Clause 2 of Article 15, Article 16 of this Circular take effect from August 15, 2025.

4. Circular No. 143/2020/TT-BQP dated December 8, 2020 issued by the Minister of National Defense guiding the implementation of certain provisions of Decree No. 146/2018/NĐ-CP dated October 17, 2018 of the Government detailing and guiding measures to implement certain provisions of the Health Insurance Law for subjects under the management of the Ministry of National Defense shall cease to be effective from the date this Circular takes effect.

5. In cases where the legal normative documents referred to in this Circular are amended, supplemented, or replaced, they shall be implemented according to those amended, supplemented, or replaced documents.

6. If the basic salary level specified in this Circular is abolished, it shall be implemented according to the regulations of the Government.

Article 26. Responsibility for Implementation

The Director of the General Logistics Department - Technical Service, heads of agencies and units, and relevant individuals are responsible for implementing this Circular./.