? What is universal health insurance
%20(1).jpg "What is universal health insurance?")
It is a social solidarity system through which high quality medical services are provided to all segments of society without discrimination.
The system includes an integrated set of diagnostic and treatment services and allows the beneficiary the freedom to choose health service providers other than the family doctor.
?What is the purpose of comprehensive health insurance
The system aims to reduce poverty and disease rates by transferring the financial burden resulting from the occurrence of the disease from the individual income of the citizen to a strong financial system.
that has the financial ability to bear this burden, and work to provide full medical protection for the family in exchange for paying contributions to the able family, while the unable family bears the treasury The public financial burden of health coverage on behalf of these families, which helps to avoid the citizen facing large expenditures on health for himself and his family, which leads to improving the lives of citizens.
?Why change the current health insurance
Because people have the right to live a healthy and safe life through an integrated health insurance system capable of achieving comprehensive health coverage and early intervention against diseases and injuries for all citizens to ensure financial protection for those who are unable, and this change was necessary for the inability of the previous health insurance to provide coverage Insurance for all citizens, especially those who are not covered and who are unable, irregular workers, business owners, university students and the rest of the family members subject to the applicable health insurance system.
Separating funding from service provision in the comprehensive health insurance system is one of the most important factors that lead to improving service quality, raising performance efficiency, having real accountability, and achieving service providers’ response to citizens’ needs and expectations.
The new system is based on purchasing health care service from all service providers. Healthcare.
What is the difference between current health insurance and comprehensive health insurance?
The current health insurance covers categories of up to 50% of the citizens, while the comprehensive
health insurance will cover all citizens.
In the current health insurance, the individual is the unit of insurance coverage, while for the comprehensive health insurance, the whole family is the unit of insurance coverage.
What is the relationship between the current health insurance and comprehensive health insurance in the transitional period until its applicationOnce the comprehensive health insurance system enters the :
Health coverage will be provided to all citizens in this governorate, and they will enjoy all treatment services for all family members, knowing that the package of services and health benefits provided in
this new system is no less than the package provided in the current health insurance system.
There will always be integration in the provision of health care between the two systems, and in the event of illness of the insured while he is in anotherlocal unity outside the application system, he will
be committed to providing health service and treatment through the Comprehensive Health Insurance Authority’s contract with the approved network of health service providers in this local unity.
New contributions will be collected for the whole family for the benefit of the universal health insurance system and will not be paid again as a percentage of social insurance contributions.
?What are the conditions for using health insurance services
It is required that the beneficiary of the comprehensive health insurance system be a subscriber to the system and pay the contributions, or one of those who are unable to bear the burden of contributions from the public treasury.
Is there an exception to the application of the comprehensive health insurance system
Comprehensive health insurance is a symbiotic system, meaning that the rich take care of the poor, the healthy person guarantees the patient, and the productive citizen guarantees the unproductive, and therefore it is a mandatory system for all citizens
?What is the entity responsible for implementing the comprehensive health insurance system
The comprehensive health insurance system is managed by three public bodies:
Comprehensive Health Insurance Authority: It is based on managing and financing the purchase of health services provided to subscribers in the system.
Health Care Authority: Hospitals, units and centers of service providers from the public sector.
Health Accreditation and Supervision Authority: It aims to ensure the quality of health services and is responsible for granting licenses to entities involved in providing health services in hospitals.
Is it permissible to provide a comprehensive health insurance service for foreigners residing or expatriating
The service may be provided to foreigners residing or coming in accordance with the controls and requirements set by the Comprehensive Health Insurance Authority, taking into account the condition of reciprocity.
What are the benefits that the citizen and his family get through the comprehensive health insurance system?
All of the following health insurance services:
Family physician and general practitioner.
Specialist doctors, including dentistry and surgery.
Treatment, hospital stay, surgery and other types of treatment.
Diagnostic imaging and laboratory services.
Rehabilitation services and replacement of prosthetic devices.
Dispensing of medicines.
Home medical care when appropriate.
Traveling for treatment abroad (according to the relevant regulations).
Dispensing medicines for oncology and chronic diseases for free.
?services are not covered by health insurance
Public health and mental health services, preventive services, emergency services, family planning services, and health services for disaster and epidemic coverage, and the state is committed to providing these services free of charge.
What is the guarantee of the quality of the health service provided and the quality of treatment
The Health Accreditation and Supervision Authority ensures that health care quality is ensured and conforms to accreditation standards before allowing service delivery units to contract with the Comprehensive Health Insurance Authority, and it monitors performance after contracting to ensure the continuity of providing a quality health service.
The Comprehensive Health Insurance Commission is also entitled to exclude any of the system service providers from the records prepared for this purpose if it is proven that he has defaulted or violated the level of medical care prescribed by the provisions of the Comprehensive Health Insurance Law or his non-compliance with the standards and requirements of the Accreditation and Oversight Commission, in addition to the existence of a fair and remunerative pricing for medical services to ensure that The patient receives a good health service without resorting to additional procedures.
A citizen has the right to file a complaint about his dissatisfaction with the level of service to the Health Accreditation and Supervision Authority, as well as to the Comprehensive Health Insurance Authority.
?Who are unable
A decision is issued by the Prime Minister specifying the criteria and targeting elements that must be met to register the citizen among those who are unable, as well as the controls related to those criteria. Ministers, provided that the state takes charge of 30-35% of the citizens at the level of the Republic.
Does the comprehensive health insurance system include people with special needs
Through the comprehensive health insurance system, the state is obligated to pay the contributions of the insured from the categories of the unable, including those with special needs whose families do not have a sufficient source of income.
What is the role of private health insurance for owners of insurance systems or private health programs
There will be a primary role for private health insurance companies, as they will cover all complementary services and hotel services that are not covered by the health services package of the comprehensive health insurance system.