Inpatient Benefits Under BVCare (New): Hospitalization, Surgery and Daily Allowance

When unexpected health issues require hospitalization, medical expenses can quickly place a heavy emotional and financial strain on employees and their families. Understanding the corporate health insurance inpatient benefits under the new BVCare program allows employees and expatriate team members to proactively choose suitable medical facilities and maximize their entitled coverage. Below is a detailed breakdown of the inpatient coverage categories according to the current policy terms.

🏥 How Inpatient Benefit Limits Are Calculated Under BVCare

Under the new BVCare rules, the sum insured (SI) for inpatient medical treatment resulting from illnesses, disease, and maternity ranges from VND 120,000,000 up to VND 1,800,000,000 per person per policy year. Employers evaluating plan structures can explore BVCare (New) Coverage Limits: Life, Accident, Inpatient, Outpatient and Dental to align tier selections with corporate budgets.

The policy structure applies a core formula known as the Sub-limit of Liability (Mức trách nhiệm phụ). Specifically: Sub-limit per person per year = Hospitalization Limit = Surgical Limit = Sum Insured / 3. Most room fees, surgical interventions, and supporting treatments are capped as a defined percentage of this Sub-limit.

🛌 Hospitalization Costs and Room & Board Caps

Hospitalization expenses caused by medical illness, routine vaginal delivery, cesarean section, or pregnancy complications are covered up to a maximum of 60 days per policy year. The policy reimburses medically necessary and reasonable medical costs prescribed by a licensed attending doctor during inpatient stays (including day-patient treatment):

• Covered hospitalization items: Room and board, standard hospital meal charges; intensive care facilities (ICU, HDU, CCU, etc.); blood, oxygen, and plasma; medications and pharmaceutical supplies; bandages, plaster casts, and intravenous infusions; diagnostic tests and medical imaging (X-rays, MRI, CT scans, ultrasounds); childbirth delivery costs and related direct medical services.
• Room occupancy principle: If an insured patient stays in a shared room containing 2 beds or more, the insurer reimburses costs corresponding only to the 01 bed assigned directly to the patient.
• Daily room and overall hospital expense cap: Total comprehensive hospital charges per day are capped at a maximum of 5% of the Sub-limit, subject to the total annual Sub-limit per person.
• Rule for corporate groups under 100 employees: For corporate teams with fewer than 100 staff members receiving treatment at private hospitals, international medical centers, or on-demand / voluntary / service / international departments (khoa tự nguyện, điều trị theo yêu cầu) within public hospitals, the room and board charge is capped at a maximum of 3% of the Sub-limit per day.

🩺 Surgical Treatment Coverage

Surgical procedures represent substantial medical costs. BVCare allocates a dedicated surgical benefit capped at 100% of the annual Sub-limit per person, paying out based on actual, reasonable expenses incurred. For an overview of how this fits into the wider package, see What Does BVCare (New) Enterprise Health Insurance Cover?.

Covered surgical expenses include:

• Surgical operations and medical procedures listed under the official Ministry of Health schedule (including day surgery).
• Operating theater charges, surgical team fees, anesthesia, pre-operative consultations, post-operative intensive recovery care, and re-operation costs.
• Prescription medications, medical supplies, and standard surgical equipment ordered by the doctor during surgery.
• Organ transplant costs (note: this specifically excludes the costs of purchasing, harvesting, preserving, or transporting donor organs, as well as any medical fees incurred by the donor).

💊 Pre-Admission, Post-Discharge, and Rehabilitation Care

To support full physical recovery beyond the actual hospital admission, the plan extends protection to associated outpatient consultations and post-stay care:

💵 Daily Hospital Cash Allowances and Additional Subsidies

To offset incidental out-of-pocket personal expenses during an admission, BVCare includes practical daily hospital cash allowances. The insured can claim one of three daily allowance tiers, up to a maximum of 60 days per year:

• Treatment at private hospitals, international clinics, or voluntary/service/on-demand wards of public hospitals: 0.1% of Sub-limit per person per day.
• Treatment at standard public hospitals: 0.2% of Sub-limit per person per day (excluding voluntary, international, or on-demand service departments).
• Treatment at public hospitals where Vietnam Social Health Insurance (BHYT) covers 60% or more: 0.3% of Sub-limit per person per day (excluding voluntary/service departments).

Additionally, the policy provides a fixed public hospital inpatient surgery subsidy of VND 2,000,000 per person per year when compulsory State Health Insurance (BHYT) settles at least 60% of the bill, as well as a funeral / burial allowance of VND 2,000,000 per case if death occurs during hospitalization.

📝 Document Checklist for Inpatient Reimbursement Claims

If you receive inpatient care at a medical facility that does not support cashless direct billing, or if you settle the hospital charges upfront, keep all documents organized for claim submission:

• ☐ Insurance claim form completed, signed, and stamped by the employer company.
• ☐ Hospital discharge summary / certificate (Giấy ra viện) — original or certified true copy.
• ☐ Itemized hospital billing statement (Bảng kê chi tiết viện phí) and valid financial VAT red invoices (hóa đơn GTGT) covering all hospitalization costs.
• ☐ Surgical report or operation certificate (Phiếu phẫu thuật / thủ thuật) if any surgical procedure was performed.
• ☐ Medical prescriptions, laboratory tests, and imaging diagnostics from the pre-admission consultation and post-discharge follow-up within 30 days.
• ☐ Written medical order / prescription from the attending doctor if claiming home nursing or specialized rehabilitation services.

Before undergoing non-emergency inpatient treatment, members are encouraged to review the contracted direct billing hospital network to utilize cashless admission services and minimize personal advance payments. For specific policy guidance or claims support, please get in touch with an insurance specialist for prompt assistance.