Key points
- Vietnam runs a mixed system: social health insurance (SHI), compulsory for formal workers and voluntary for informal workers, alongside free care for veterans and disadvantaged groups.
- Coverage has expanded fast: 93% of the population was covered by public health insurance in 2023, up from 58% in 2009.
- Care is delivered by commune health stations and village health workers for primary care, and by district, provincial and national hospitals.
- SHI typically covers up to 80% of costs with a 20% co-payment, and households paid 39.2% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database).
- Life expectancy at birth was 74.3 years in 2023, and health spending was 4.6% of GDP in 2023 (WHO Global Health Estimates; World Bank, WHO Global Health Expenditure Database).
Direct answer: Vietnam runs a mixed system: social health insurance (SHI), compulsory for formal workers and voluntary for informal workers, alongside free care for war veterans and economically disadvantaged groups. Coverage has expanded fast: 93% of the population was covered by public health insurance in 2023, up from 58% in 2009. Care is delivered by commune health stations and village health workers for primary care, and by district, provincial and national hospitals. SHI typically covers up to 80% of costs with a 20% co-payment, and households paid 39.2% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database). Life expectancy at birth was 74.3 years in 2023 — and healthy life expectancy 65.5 years — and health spending was 4.6% of GDP in 2023 (WHO Global Health Estimates, October 2026; World Bank, WHO Global Health Expenditure Database).
At a glance
| Item | Detail |
|---|---|
| Model | Mixed — social health insurance (SHI) |
| Who pays | Employer, individual and government contributions to SHI, plus out-of-pocket payments on top |
| Who delivers | Commune health stations and village health workers for primary care; district, provincial and national hospitals for the rest |
| What is free at the point of use | Inpatient and outpatient care fully covered at commune-level hospitals; low-income households, people over 80 and children under 6 are covered in full |
| Life expectancy at birth | 74.3 years (2023, WHO Global Health Estimates) |
| Health spending | 4.6% of GDP (2023, World Bank, WHO Global Health Expenditure Database) |
| Source for the model and coverage | Commonwealth Fund — Vietnam country profile |
Figures are a snapshot checked 7 November 2026, not a live feed. No country is ranked as best.
How the system works
Vietnam’s health insurance has roots in the social health insurance of the Democratic Republic of Vietnam from 1945 to 1975. After Đổi Mới in 1986 moved the country from a command economy towards market economics, the system was rebuilt around social health insurance. Today Vietnam Social Security is the government agency that implements SHI, collects premiums, contracts with providers and manages the funds transparently (Commonwealth Fund).
The first point of contact is primary care at commune health stations, delivered by general practitioners and village health workers — nearly 98,000 village health workers in 2020, critical in underserved rural areas. District and provincial hospitals provide secondary care, and national and specialist hospitals, managed by the Ministry of Health, provide tertiary care. Providers are paid by capitation, fee-for-service — the most commonly used — and diagnosis-related group payments, all in use since 2014.
Who pays, and what people pay
All citizens employed for more than three months, civil servants, people with disabilities and veterans are automatically enrolled in compulsory SHI schemes, while self-employed and informal workers can opt into voluntary schemes. The system is funded by contributions from employers, individuals and the government: in 2022 the government accounted for 43% of health expenditure and prepaid private spending for 16%. People with SHI are typically covered for up to 80% of health care costs, with a 20% co-payment. What people still pay is substantial: about 40% of total health care spending is out of pocket — 39.2% in 2023 (WHO Global Health Expenditure Database) — roughly the same share as the government pays, and financial protection remains the programme’s weak point.
What is free, and what is not
Inpatient and outpatient care are fully covered at commune-level hospitals, and some groups are covered in full wherever they are treated: low-income households, people over age 80, children under age 6, members of ethnic minority groups in disadvantaged areas, retired workers and recipients of certain social and disability allowances. What is not free is the margin: the typical 20% co-payment outside commune hospitals, limited cover for dental care, basic eye care, mental health care and assistive devices, and no cover at all for home visits, palliative care or long-term care. Tuberculosis services were integrated into SHI in 2022, but patients must use SHI at district-level facilities or pay out of pocket.
How it compares
Vietnam spends 4.6% of GDP on health (2023), below the OECD average of 9.3% (2024), and its life expectancy of 74.3 years is 6.8 years below the OECD average of 81.1 years (2023). Vietnam is not in the OECD tables, so its figures come from WHO and World Bank sources for 2023 rather than the OECD’s 2024 dashboards. Its distinguishing feature is the speed of the coverage expansion — from 58% in 2009 to 93% in 2023 — combined with a thin financial-protection floor: a 20% co-payment on most care and out-of-pocket spending of 39.2%, high for a system covering 93% of the population. Compare countries side by side in the Health System Comparison tool, or read the other profiles in the country index.
Frequently asked questions
What is SHI?
Social health insurance — Vietnam's public health insurance system, run by Vietnam Social Security. Formal workers, civil servants, people with disabilities and veterans are enrolled automatically; self-employed and informal workers can opt into voluntary schemes.
Who is covered automatically?
All citizens employed for more than three months, civil servants, people with disabilities and veterans. Low-income households, people over 80, children under 6, retired workers and members of ethnic minority groups in disadvantaged areas are covered in full — 100% of costs.
What do patients pay?
Typically 20% of the cost: SHI covers up to 80% of health care costs, with inpatient and outpatient care fully covered at commune-level hospitals. Households paid 39.2% of health spending out of pocket in 2023, because co-payments, private care and services outside SHI still add up.