Decree No. 253/2026/ND-CP introduces two new deductions for salaried taxpayers: medical expenses and education/training expenses for the taxpayer and their dependants. The conditions attached are fairly strict, and there is one consequence many employees don’t yet know about: to claim this deduction, the employee cannot authorize the employer to file the annual tax finalization on their behalf.
On 18 September 2026, the Hanoi Tax Department issued Official Letter No. 47199/HAN-QLDN5, addressed to the Department of Health, the Department of Education and Training, ward-level People’s Committees, and enterprises, organizations and individuals in the city, consolidating the relevant rules for uniform implementation.
Quick summary
| Expense category | Maximum deduction and scope |
|---|---|
| Healthcare | Total capped at VND 23 million/year — medical examination and treatment at domestic health facilities, within the scope covered by health insurance. Requires an invoice and a statement of medical examination/treatment costs |
| Education and training | Total capped at VND 24 million/year — tuition for preschool, general education, vocational education, higher education and other professional skills training at domestic education institutions. Requires invoices/vouchers |
1. Legal basis: Clause 2, Article 49 of Decree 253/2026/ND-CP
Clause 2, Article 49 of Decree No. 253/2026/ND-CP dated 30 June 2026 provides that a taxpayer who is a resident individual may deduct, from taxable income before tax is calculated, on employment income (salaries and wages), expenses for healthcare and education/training incurred for the taxpayer and their dependants, comprising:
- Point a — expenses for medical examination and treatment at domestic health facilities within the scope covered by health insurance, capped at a total of VND 23 million/year;
- Point b — expenses for education and training at domestic education institutions, capped at a total of VND 24 million/year, specifically: tuition fees for preschool, general education, vocational education and higher education under education law, and other professional skills training at education institutions.
Four scope limits worth reading carefully directly from the source rule:
- Applies only to resident individuals.
- Deductible only against income from salaries and wages — not all types of income.
- Only expenses incurred at domestic facilities.
- For healthcare, only the portion within the scope covered by health insurance — services outside that list don’t count.
The VND 23 million and VND 24 million caps are set as the total per year for expenses of the taxpayer and their dependants combined. The rule does not set a separate cap per dependant.
2. Three mandatory documentation conditions
Clause 3, Article 49 of Decree No. 253/2026/ND-CP sets three conditions, all of which must be satisfied:
Condition a — invoices/vouchers as prescribed. For healthcare expenses specifically, a Statement of medical examination/treatment costs used at medical facilities under the Minister of Health’s regulations is additionally required.
Condition b — the invoice/voucher must show the information of the taxpayer or the dependant. An invoice without personal information cannot be used.
Condition c — the expense must not have been paid from other sources, including funding, support or reimbursement from organizations or individuals, state budget sources, social insurance funds, health insurance, or insurance payouts in any form.
Condition c is very broad in scope: any portion covered by insurance (including company-purchased health insurance), employer support, or reimbursement by someone else is excluded. Only the portion the employee directly pays out of pocket counts.
3. How to get a compliant invoice at a hospital
This is the most practical point in the official letter, because the default invoicing mechanism at health facilities does not record the patient’s name.
Under Point m, Clause 4, Article 9 of Decree No. 254/2026/ND-CP, a medical facility that uses management software and prints payment receipts, where a customer does not request an invoice, must consolidate the day’s examination/treatment information and payment receipts at the end of the day to issue a consolidated invoice for the medical services provided that day. Where a customer requests an e-invoice, the medical facility must issue an e-invoice to that customer.
Item b, Clause 4 of the Appendix to Decree No. 254/2026/ND-CP provides: if the buyer, as a consumer, provides their name, address and personal identification number, the invoice must show that information; if not provided, the invoice must clearly state “Sold to a consumer”.
Combining these two rules with Condition b under Clause 3, Article 49 of Decree No. 253/2026/ND-CP produces a very concrete consequence: the patient must proactively request an invoice and provide their personal information at the payment counter. Otherwise, that expense will fall into the end-of-day consolidated invoice, which carries no buyer name and will not meet the deduction condition.
On the cost statement: Decision No. 697/QD-BYT dated 19 March 2026 of the Ministry of Health requires that, for each examination/treatment visit, the facility prepares one statement for its own records and one statement to give the patient. Facilities that have implemented electronic medical records must prepare an electronic statement and provide it to the patient electronically, rather than a paper statement; a fully digitally signed electronic statement has the same legal value as a paper one.
4. Expenses that are not eligible for the deduction
Clause 4, Article 49 of Decree No. 253/2026/ND-CP excludes two groups to prevent double benefit:
Group 1 — amounts already excluded from taxable income under Points b, g and i, Clause 4, Article 8. The official letter specifies these as income items that are not in the nature of salary or wages, comprising:
- Point b — employer-paid support for medical examination/treatment of a life-threatening illness for the employee and their relatives (biological, adopted or step-children; spouse; biological parents; parents-in-law; step-parents; adoptive parents). The amount excluded from taxable income is the actual support amount per invoices/vouchers, capped at the hospital fee actually paid after deducting any amount covered by insurance (if any).
- Point g — tuition for the children of foreign employees studying in Vietnam, or children of Vietnamese employees working abroad studying overseas, from preschool through upper-secondary level, paid or reimbursed by the employer.
- Point i — expenses paid by the employer for upskilling or vocational training of an employee that is relevant to their job or professional duties, or under the employer’s training plan.
Group 2 — healthcare expenses already granted tax reduction under Article 40. The official letter states that healthcare expenses (for life-threatening illness) under Article 40 of Decree No. 253/2026/ND-CP fall under tax reduction, and therefore cannot also be claimed as a deduction.
The general principle: an expense can only receive one tax benefit, under one mechanism.
5. The biggest consequence: mandatory self-finalization
Clause 3, Article 51 of Decree No. 253/2026/ND-CP provides that where, during a tax period, an individual requests a tax reduction for natural disaster, epidemic, fire, accident or life-threatening illness under Article 40, or has deductions arising under Article 49 and requests that they be deducted from income before tax is calculated, the taxpayer must self-file their own tax finalization.
Official Letter 47199/HAN-QLDN5 states this directly: an employee who requests the education/healthcare deduction cannot authorize the paying organization to finalize tax on their behalf and must self-file their personal income tax finalization.
For employers, this is a meaningful process change: the number of employees authorizing the employer to finalize tax on their behalf will fall, and HR teams need to identify early which employees will self-finalize so they can coordinate on providing tax-withholding documentation.
6. Illustrative examples
The examples below assume the expense is incurred on or after 1 July 2026, and that the taxpayer is a resident individual with employment income.
Example 1 — Medical expense partly covered by insurance
Mr. A pays a total of VND 30 million for medical examination/treatment for himself and his child (a dependant), all within the scope covered by health insurance, at a domestic hospital. The invoice is in Mr. A’s name, with a cost statement in the prescribed form. Company-purchased health insurance covered VND 10 million of this.
- The VND 10 million covered by insurance is excluded under Condition c, Clause 3, Article 49.
- The VND 20 million Mr. A paid himself is below the VND 23 million cap.
- Deductible amount: VND 20 million. Mr. A must self-file his tax finalization.
Example 2 — Tuition exceeding the cap
Ms. B pays VND 40 million in tuition for her child’s primary education at a domestic school, entirely out of pocket, with the invoice in her own name.
- Deductible amount: VND 24 million — the cap under Point b, Clause 2, Article 49. The excess of VND 16 million does not qualify.
Example 3 — Foreign employee, employer pays the child’s tuition
Mr. C is a foreign employee working in Vietnam. His child attends an international school in Hanoi, with tuition paid by the employer.
- This tuition falls under Point g, Clause 4, Article 8, and is already excluded from Mr. C’s taxable income.
- It therefore cannot also be claimed as a deduction under Clause 4, Article 49.
This is a special case FDI employers should note: international-school tuition for the children of foreign experts is already benefiting from a separate mechanism and the two cannot be stacked.
Example 4 — Invoice without the patient’s information
Ms. D visits a clinic and pays VND 5 million but does not request an invoice. The clinic later issues a consolidated end-of-day invoice under Point m, Clause 4, Article 9 of Decree No. 254/2026/ND-CP, marked “Sold to a consumer”.
- The invoice does not show the taxpayer’s or dependant’s information → fails Condition b of Clause 3, Article 49.
- No deduction is allowed, even though the expense is genuine and within the health-insurance-covered scope.
7. What employers should do
The official letter asks employers and organizations to communicate and raise awareness among all employees. In practice, employers should:
- Inform employees about invoice conditions — in particular, that they must proactively request a named invoice at health facilities and keep the cost statement.
- Review existing benefit policies: health insurance, hospital-fee support, tuition reimbursement, training support. Amounts already paid or supported by the company cannot also be used by the employee for this deduction.
- Adjust the PIT finalization process: identify early which employees want to claim the healthcare/education deduction, exclude them from the authorization list, and prepare tax-withholding documentation for them.
- For FDI employers with foreign experts: note Example 3 specifically — tuition paid by the employer for a foreign expert’s child already has its own separate mechanism under Point g, Clause 4, Article 8.
Disclaimer
This article is based on Official Letter No. 47199/HAN-QLDN5 dated 18 September 2026 issued by the Hanoi Tax Department on implementing personal income tax deductions for healthcare and education expenses, and the regulations cited within it:
- Clauses 2, 3 and 4, Article 49; Points b, g and i, Clause 4, Article 8; Clause 3, Article 51 of Decree No. 253/2026/ND-CP dated 30 June 2026 of the Government detailing implementation of the Law on Personal Income Tax;
- Clause 1, Article 4; Clauses 2 and 4, Article 9; Item b, Clause 4 of the Appendix to Decree No. 254/2026/ND-CP dated 30 June 2026 of the Government on e-invoices and e-documents;
- Article 2 of Decision No. 697/QD-BYT dated 19 March 2026 of the Ministry of Health issuing the template for the medical cost statement.
Four points remain unclear in the official letter and should be monitored:
- Expenses incurred before 1 July 2026. The official letter states the deduction rules apply “from 1 July 2026” but does not clarify whether expenses incurred in the first six months of 2026 may be counted in the 2026 tax finalization period. Taxpayers should check the effective-date and transitional provisions of Decree No. 253/2026/ND-CP.
- The list of items covered by health insurance and the list of life-threatening illnesses are determined under regulations of the Minister of Health and are not set out in this official letter.
- Article 40 of Decree No. 253/2026/ND-CP on tax reduction for life-threatening illness is only referenced, not quoted in full, in the official letter.
- This article is based on the portions quoted in the official letter, not on the full text of Decree No. 253/2026/ND-CP or Law on Personal Income Tax No. 109/2025/QH15.
Official Letter No. 47199/HAN-QLDN5 is an implementation guidance document issued by the Hanoi Tax Department to units within Hanoi; it is not a legal normative document. Taxpayers in other localities should check the guidance of their own managing tax authority.
This article is for reference only, does not replace the original legal text, and does not constitute advice for any specific case. Businesses and individuals should verify against the current regulations at the time of application and consult a qualified advisor before making decisions.
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