As an expat planning to travel or move to Vietnam, one of the most important things to learn about is the healthcare system, what kind of quality you can expect from it and what you’ll have to do in order to access it and cover your medical expenses.
Vietnam’s healthcare is improving
While Vietnam’s healthcare system isn’t as robust as some of its neighbours’, it is working on improving both its health insurance coverage, which reached 77% of the population in 2015, as well as the capabilities of its healthcare infrastructure, especially in terms of quality in rural areas. While improvements have been made, there is still a long way to go before healthcare reaches a level on par with Western hospitals.
Public vs private healthcare in Vietnam
Vietnam is currently undertaking a plan to improve their healthcare provisioning, based on their four levels of facilities (central, provincial, district and commune), in an attempt to provide better primary care at local levels to reduce the burden on central and provincial medical facilities. However, as it stands, public hospitals and clinics in Vietnam are frequently underfunded and poorly equipped, with services largely being available in Vietnamese only. The better provisioned public hospitals in major cities like Hanoi and Ho Chi Minh are frequently overcrowded, reaching 120-160% bed occupancy as they not only serve the needs of Vietnamese citizens residing in the cities, but also people traveling in from the surrounding countryside for treatment which may be unavailable in their location.
As an expat in Vietnam, you will want to visit private hospitals and clinics as they are better equipped, less crowded and the doctors are better-trained, frequently having studied overseas. Additionally, most doctors at private clinics and hospitals will usually be able to speak either English or French so you can avoid the frustration of miscommunications about your health.
The quality of healthcare between cities vs rural location
Most of the private hospitals and clinics that can provide you with high quality care tend to be clustered around Vietnam’s major urban areas, as are the most advanced and well-equipped public hospitals. In the more rural areas of Vietnam, accessing quality healthcare is more challenging, as many locations lack the diagnostic equipment and training to carry out some treatments.
The Vietnamese government is making efforts to improve public healthcare in rural areas through Project 1816, also known as the satellite hospital programme. This initiative sees medical experts from central-level hospitals being rotated through local hospitals to train their colleagues on the procedures and devices necessary to provide more treatment options locally, rather than forcing patients to have to travel to major cities.
Comparing local vs international health insurance plans in Vietnam
For expatriates living in Vietnam, you will want to take out a private medical insurance policy to cover the costs of treatment at private hospitals and clinics. Your two options are to either purchase a local or international health insurance plan, which come with quite a few differences.
One of the largest differences between the local and international plans are the way benefits are structured and what limits are placed upon them. Benefit limits are the total amount of money an insurance plan will cover treatment up to. Almost every medical insurance policy will come with an annual limit, but depending what plan you choose it may come with specific limits for certain kinds of things such as for cancer or pregnancy complications.
Generally, local Vietnamese insurance plans will come with lower total benefit levels and often include other limits on the benefits, such as a limit on the amount covered per day or per visit. International medical plans on the other hand usually offers higher benefit levels with fewer limitations.
Having a lower annual limit, or more specific limits on your plan’s benefits opens you up to additional out of pocket expenses which can influence where you seek treatment if you’re trying to avoid those extra costs.
Ability to offer direct billing
One area where local insurance providers excel is that they usually have extensive direct billing networks for both inpatient and outpatient healthcare providers.
Depending on which international insurance company you purchase a medical insurance plan with, they may have a more limited direct billing network in Vietnam, especially when it comes to outpatient treatments.
Freedom of treatment
For some planned surgeries, you may need to seek treatment outside of Vietnam, either because the standard of care is higher somewhere like Singapore, or because the treatment is simply not available in Vietnam, even in private hospitals or clinics.
For international medical plans that offer Worldwide or Worldwide Excluding-USA coverage, this will not be a problem. Simply let your insurer know ahead of time and they can arrange to pay for all treatment directly so you won’t even have to pay first and file a claim.
For local insurance providers, this can often be an issue as the insurance policies are priced for the cost of treatment in Vietnam. If the local provider agrees to cover the cost of a treatment outside of Vietnam at all, it will often be after a long process to get the agreement, and it may come with additional restrictions such as stricter limits on some benefits or a co-insurance on the costs.
Calculating renewal premiums
When figuring out how much premiums need to rise at renewal, insurers use one of two methods: experience rating or community rating. Other things insurers take into account at renewals are medical inflation, people’s increasing age, and changes in benefits which can affect your premium.
Experience rating means that at renewal the insurer reviews your claim history for the year before deciding how much to raise the premium. So, if you have a year of low claims, your premium won’t rise much, but if you’ve had a high claims year, then your premium will likely see a dramatic rise at renewal. Most local Vietnamese insurers use experience rating when calculating renewal premiums on private health insurance.
There are other concerns, such as if you have multiple years with high claims, or have developed a chronic condition that requires recurring treatment. This could cause your premium to be so high after a few renewals that it is simply unaffordable anymore. Alternatively, your insurer may add limits, co-insurance or deductibles on some benefits, or simply decline to renew your policy, which leaves you looking for health insurance with a serious pre-existing condition.
The other way insurers calculate renewal premiums is community rating, which means that instead of looking at individual cases they examine the performance of everyone insured under a product and then based on the performance of the portfolio apply a fixed premium increase to everyone. While this does protect both your ability to get treatment and your finances if you have had a run of bad luck, it also means that your premium will rise even if you’ve been healthy that year.
Insurance for Expatriates in Vietnam
MyHEALTH offers you the best of both worlds in Vietnam; the great benefits of an international medical insurance plan with the easily accessible customer service and direct billing network of a local insurance company.
Whether you just need to cover yourself, or need to insure your family as well, you can build your own plan that suits your personal situation. In addition to our inpatient plan, which includes cover for major treatments such as kidney dialysis, cancer treatments or even organ transplants, you can also add outpatient, maternity and dental & optical benefits modules and choose one of three levels of coverage for each module.
MyHEALTH offers you a flexible coverage option that will cover you in hospitals across the world, not just in Vietnam. Plus, if you ever move out of Vietnam, your MyHEALTH plan is globally portable and can travel with you to your new home with no breaks in coverage at all.