Vietnam runs a compulsory Social Health Insurance scheme (BHYT, administered by Vietnam Social Security) that is mandatory for formal employees and civil servants and government-subsidized for the poor, alongside a fast-growing private hospital sector that most expats end up relying on. Here is what that actually means for an American or Briton living in Vietnam: what the public system gives you, what it does not, and where private cover fits.
Can you use the public system?
- Working for a local employer: Yes, by paying contributions
- Self-employed: Only in limited cases
- Retired or not working: No
Foreign employees are covered only if they hold a valid work permit (or work-permit exemption certificate) and an indefinite or at-least-12-month labour contract with a Vietnam-based employer; enrolment in Social Insurance and compulsory Health Insurance then becomes mandatory, with the employer paying 3.0% (health) within its 20.5% total SI/HI share and the employee paying 1.5% within their 9.5% share (2022 rates, unemployment insurance excluded for foreign workers), subject to a monthly salary cap. There is no employment-based route for the self-employed or non-working retirees. A ‘voluntary BHYT’ scheme nominally exists, but secondary sources describe it as accessed through registration as a member of a Vietnamese household, which is impractical for most foreign residents without close Vietnamese family ties. Vietnam also has no dedicated retirement visa; long-stay retirees typically use an investor visa, family-sponsorship visa, or renewable Temporary Residence Card, none of which carry health-insurance entitlements. There is no US or UK reciprocal healthcare agreement with Vietnam.
If you are retiring here
Non-working retirees have no employment link and therefore no route into Vietnam’s compulsory Social/Health Insurance system; the only nominal fallback, voluntary BHYT, is tied to household registration and is not a realistic, accessible route for most foreign retirees. Combined with the absence of a dedicated retirement visa, non-working retiree expats in Vietnam are effectively excluded from public healthcare and depend entirely on private/international insurance or self-funding.
What public cover will not give you
- No compulsory public cover at all for self-employed and non-working (including retired) foreigners
- Public hospitals are largely Vietnamese-language only and can be overcrowded, especially outside Hanoi, Ho Chi Minh City, and Da Nang
- Even where BHYT applies, reimbursement is partial (around 80% at a registered primary facility, dropping to about 40% at non-designated municipal hospitals), leaving real out-of-pocket exposure
- No meaningful private-hospital, English-speaking-specialist, or medevac coverage under the state scheme; many expats and wealthier locals travel to Bangkok or Singapore for serious treatment
- Ambulance response times and equipment standards are inconsistent outside major cities
So do you need private health insurance?
Private/international health insurance is not a legal requirement for any current Vietnam visa category (tourist, business, work, investor, or long-term residence) as of mid-2026, but it is de facto essential for most expats: it is the only realistic way for the self-employed, retirees, and dependents to access decent care at all, and even insured employees commonly add private cover since state BHYT reimbursement is partial and largely confined to Vietnamese-language public facilities. Proof of health insurance is also a condition of the main residence routes here, so most expats need a policy in place before they apply.
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General information, not insurance, immigration or medical advice. Rules change and individual situations differ; check the official position before you commit. Researched from official sources, July 2026.