Nobody in Vietnam will ever ask you for a policy
Vietnam is one of the clearest no cases in Asia, and it is worth stating flatly before anything else. There is no health insurance requirement to enter or stay in Vietnam. Not for the e-visa, not for visa exemption, not for a business visa, not for a temporary residence card.
The Immigration Department's own e-visa portal spells out the conditions, and there are three: you are outside Vietnam, you hold a valid passport, and you are not subject to suspension of entry under Article 21 of the entry law. That is the whole test. The 90-day e-visa, single or multiple entry, has been open to citizens of every country and territory since Resolution 127/NQ-CP took effect on 15 August 2023 alongside Law 23/2023/QH15, and it costs a widely reported 25 dollars single entry or 50 dollars multiple.
The exemptions are equally bare. Thirteen countries got 45 days under Resolution 128/NQ-CP in August 2023. Twelve more European countries were added by Resolution 229/NQ-CP, effective 15 August 2025 and running to 14 August 2028, with exactly two conditions attached: a passport valid at least six months, and not being barred under the entry law. No policy, no proof, no declaration.
There was a requirement once. During the pandemic Vietnam asked arrivals to hold travel medical insurance covering at least 10,000 dollars of COVID-19 treatment. All COVID-19 entry rules were lifted on 15 May 2022, and in June 2022 the Ministry of Culture, Sports and Tourism formally proposed scrapping the insurance condition on the grounds that treatment was no longer expensive. If a page still lists that 10,000 dollar figure, it has not been updated in four years.
The visa that does not exist, and the one that does
Two related corrections, because they drive a lot of bad advice. Vietnam has no digital nomad visa in 2026. The much-shared 5 to 10 year "golden visa" was a proposal submitted by the Tourism Advisory Board to the Prime Minister in early 2025 and it has no decree number, no legislative schedule, and no application channel.
What does exist is Decree 221/2025/ND-CP, effective 15 August 2025, creating a Special Visa Exemption Card. It runs up to five years with a maximum 90 days per stay, and it is aimed at CEOs, investors, scientists, professors, engineers, senior IT personnel, artists and athletes, normally requiring endorsement by a Vietnamese university, research institution or large corporation. It is a talent-attraction instrument, not a nomad route, and it does not ask for insurance either.
The one place Vietnam does compel cover
There is exactly one compulsory insurance regime here, and most nomads cannot get into it. Foreign employees on a fixed-term contract of twelve months or more, or an indefinite contract, with a Vietnam-based employer are compulsorily enrolled in social insurance, which includes BHYT state health cover. Under the 2024 Law on Social Insurance, effective 1 July 2025, the trigger is contract length rather than permit type. The combined contribution is 30 percent of insurable salary, split 20.5 percent employer and 9.5 percent employee, which is two points below the 32 percent Vietnamese nationals pay because foreigners are outside the unemployment scheme.
If you are working for foreign clients on an e-visa, none of that reaches you. You have no Vietnamese employer, so you cannot be enrolled, and there is no voluntary buy-in. You are a private payer in a country that has no obligation to treat you on credit.
What care actually costs, from a published price list
Here is where Vietnam gets genuinely reassuring, and then genuinely expensive.
Vinmec publishes its international service prices, effective 6 January 2026. A general consultation is 440,000 VND. A specialist with an appointment is 690,000 VND, or 1,100,000 VND without one. Accident and emergency with a general practitioner is 1,800,000 VND, the same as an out-of-hours specialist. A consultation with a professor is 2,500,000 VND, a follow-up is 330,000 VND, and a full blood count is 253,000 VND. At roughly 26,000 VND to the dollar, an emergency room visit is under 70 dollars. Day-to-day medicine here is affordable enough that insurance is not what gets you through it.
The serious end is a different business. Pacific Cross Vietnam publishes a medical cost guide that puts a simple appendectomy near 2,500 dollars, a private hospital room at 125 to 250 dollars a night, about 500 dollars a day while admitted, a broken leg near 2,500 dollars, a torn ligament at 5,000 to 12,000 dollars, and repatriation of remains at 7,500 to 12,000 dollars. That document is dated 2012, so treat the absolute numbers as a floor rather than a quote. The line that has not got cheaper is the last one: an air ambulance from Vietnam to Bangkok, about 30,000 dollars.
And you pay first. Deposits before admission are standard at both public and private hospitals, sized to the estimated cost of care. Hanoi French Hospital says so in its own pricing policy: when an admission order is issued, you are required to make an advance payment. Evacuation is worse, because an air ambulance needs insurer pre-authorisation or money up front before it leaves the ground.
The number that should decide this
Vietnam's roads are the reason to buy a policy in a country that does not ask for one. In the first ten months of 2025 the National Statistics Office recorded 15,251 crashes, 8,515 deaths and 10,204 injuries. That is genuine improvement, with deaths down 7.2 percent and injuries down 30.2 percent year on year, and it is still a fatality rate of 17.7 per 100,000 people, above the Asia-Pacific average of 15.2 and the Southeast Asia average of 14.4, per the Asian Transport Observatory's 2025 road safety profile.
Most nomads here ride a motorbike daily. The realistic bad day is not a mystery illness, it is a collision in Da Nang or District 1 that turns into surgery, a week admitted, and possibly a flight to Bangkok.
Buy for the evacuation, not the consultation
This shapes what to buy. Local Vietnamese policies from Bao Viet, PVI or Liberty are cheap, direct-bill at Vietnamese private hospitals, and are the wrong tool on their own, because they stop at the border and carry limits that will not fund an international transfer. An international travel-medical policy is the right base layer, and the specification to check is the evacuation limit rather than the headline medical maximum.
You can also use public hospitals. Foreigners are treated at the non-subsidised rate, and Bach Mai in Hanoi and Cho Ray in Ho Chi Minh City run dedicated foreign-patient units with English-speaking staff. Expect upfront payment, long waits, and registration desks with no English.
The visa page covers the 90-day e-visa rhythm and why none of it builds toward residency, and Da Nang is where most of this plays out in practice.