health insurance in egypt the most important faq about health insurance Blog Image

health insurance in egypt the most important faq about health insurance

3 December 2022

Nowadays, having Health insurance in Egypt for all family members has become an indispensable necessity, any family member who falls into a Medical crisis needs many procedures such as tests, radiology, examinations, and many tests that are usually required by Health Service Providers, does Health insurance cover this

It is already known that private companies, as well as government sectors, are interested in providing health insurance that includes most and even all procedures, in order to protect employees in most health conditions and provide a complete overview of all their requirements at the time of any health problem.

But recently; the government announced the application of a comprehensive health insurance system with a new integrated system, to start from Port Said governorate last July 2021, to be applied through an upcoming executive plan to all governorates of Egypt to include all its citizens, and the new Health insurance system aims to:

  • Inclusion and coverage of all Egyptians in all governorates.

  • Comprehensive Health insurance should provide quality health services at a high level that satisfies all citizens.

  • To achieve financial sustainability to continue to apply،

  • To have the necessary flexibility to develop and face the challenges facing it, and to avoid the challenges of the old system.

All these previous goals the new system seeks to implement, will it achieve them? How can citizens fall under this comprehensive medical list? Let's get to know more full details on the topic.

What is universal Health insurance?

It is Health insurance that relies on a social solidarity system to provide high-quality medical services without discrimination between any member of society, in which the state sponsors those who are unable to afford the costs of participating in Health insurance.

The system includes a full range of diagnostic and therapeutic services and allows the beneficiary the freedom to choose health service providers other than the family doctor.

What are the advantages of having universal Health insurance In Egypt?

There are many advantages of having comprehensive Health insurance, and it includes the following:

  • Universal Health insurance provides therapeutic and diagnostic services, reproductive health services, and emergency first aid.

  • The citizen costs 5% of surgical operations with a maximum of 400 pounds, regardless of the type or cost of the surgery.

  • The citizen costs no more than 10% with a maximum of 1000 pounds in dispensing medicines and monthly treatments.

  • The citizen costs a percentage not exceeding 10%, with a maximum of 750 pounds of the cost of radiology and analysis at a time.

  • The State exempts those who are unable to afford the subscription cost as well as exempts them from bearing the contribution to treatment, radiology, and analysis.

  • The State shall exempt people with tumors and chronic diseases from bearing the costs and percentages of contribution to treatment.

  • Treatment costs outside the Universal Health Insurance Authority are reimbursable in cases of emergency only.

  • The comprehensive Health insurance system allows citizens to benefit from the insurance systems available in the country until such a system is applied in the governorate to which the individual belongs.

Are there Health insurance companies in Egypt that share universal Health insurance?

No, Health insurance companies are not subject to this type of insurance, but this insurance includes all members of society and most importantly those who are unable to afford treatment or health insurance.

How to make Health insurance In Egypt?

If you want to make comprehensive Health insurance for you and your family, you must follow these steps:

  1. Bring the national ID card of the breadwinner as well as family members and birth certificates of minors.

  2. If the breadwinner works - or a family member - the social insurance statement must be submitted to the insured (government/public / private sector employee) showing the sector number and including the sector number according to the following: (government - public/private ... self-employment or other)

  3. A statement that includes the value of the comprehensive Health insurance contribution during the months and pays the payment.

  4. A statement of the functional periods so that the insurance period is not less than 3 consecutive months and six separate to ensure that the employee is stable at work.

  5. A copy of the marriage certificate for married children.

  6. Divorce document in case of divorce of the wife or one of the breadwinner's daughters.

  7. A copy of the death certificate of a family member to stop usufruct.

  8. Guardianship decision for minors in case of divorce or death of the breadwinner.

What is Cancer Care Insurance in Egypt?

Cancer Care Insurance is a social solidarity Health insurance that aims to treat its participants at the highest level, in the best cancer treatment centers in the Middle East.

The purpose of making cancer insurance is to reduce the financial burden borne by the cancer patient and to provide financial support to policyholders.

How and what type of material support is provided depends on the type of policy listed between the insured and the insurance company, as in other types of insurance, in which the insured pays a monthly or annual amount for the policy that varies depending on the type of risk associated with the person.

Benefits of Having cancer Care Insurance In Egypt

  • It does not require Health approvals or prior procedures before entering the center.

  • Subscription is available for all ages, nationalities, individuals, and businesses.

  • Discounts on radiology and tests in addition to free annual examination.

  • Average subscription costs, for the addition of an appropriate coverage limit, are determined according to the type of each case to provide maximum benefit.

  • Maximum coverage even if you have cancer on the last day of the subscription.

  • Cover treatment costs.

  • Conducting periodic examinations aimed at early detection of cancer and monitoring other aspects of public health, and these examinations include:

    • Mammography.

    • Pap smear tests.

    • Colonoscopy.

    • Many other examinations are specifically related to the patient.

What parts are covered by cancer care insurance In Egypt?

This policy covers full cancer coverage, including:

  • Inpatient and outpatient treatment.

  • Follow-up treatment costs such as home visits, nursing burdens, and psychological care.

  • Remote consultation costs.

What is Critical Illness Insurance In Egypt?

Known as incurable disease insurance, the patient can receive comprehensive coverage that covers treatment, radiology, and examinations required for critical diseases such as tumors, cancers, stroke, and others.

Previously, survival rates from these diseases were not high, but thanks to advances in medicine, the cure rate for these diseases, which were previously considered fatal and in which the patient incurred high costs has increased beyond the ability to bear.

The existence of Health insurance helps cover the expenses of these diseases, but to a certain extent, the expenses of covering examinations and treatments for them are very high, which makes them insufficient to cover the remaining part of the cost of staying in the hospital and so on.

The aim of having critical illness insurance is to reduce the financial burden on people with illness, in addition to supplementing the benefits of medical coverage provided by public Health insurance.

What conditions are covered by critical illness insurance In Egypt?

Doctors differ on the description of patients as terminally ill, but within this difference, all of the following diseases can be classified as critical,:

  • Cancers, including certain types of cancer?

  • Strokes.

  • Heart attack.

  • Paralysis.

  • Renal failure.

  • Coronary artery bypass or angioplasty.

  • Transplantation and transfer of various bodily organs.

  • Alzheimer's.

What expenses does critical illness insurance In Egypt cost?

A critical illness insurance policy offers benefits not offered by other policies, as it pays for:

  • Mortgage payments.

  • Treatment costs are not covered by regular health insurance.

  • Travel costs for medical care.

  • Credit card bills.

  • The insured shall recover such payments at its sole discretion.

How does the patient get the amounts due from critical illness insurance In Egypt?

The way insurance companies refund the policy amount to the insured varies, but in most cases, insurance companies provide a certain amount when the policyholder is diagnosed with an incurable illness.

When should you buy a critical illness insurance policy In Egypt?

Cases vary, but in this decision, you need to discuss it with your doctor and a financial expert to know your individual situation and determine the extent to which you need such documents.

Which governorates are covered by universal Health insurance In Egypt?

The government announced the implementation of the law on the implementation of universal Health insurance for all citizens over a period of fifteen years starting from 2018 until 2032.

The beginning of the application of comprehensive insurance was the "first stage" in the governorates of each of:

  • Ismailia.

  • Suez.

  • South Sinai.

  • Luxor.

  • Aswan.

And it was applied during the time period from 2018 to 2020.

The second stage includes each of the following:

  • Sohag.

  • Minya.

  • Kafr El-Sheikh.

  • Qalyubia.

  • matrouh.

This is the current phase, which was implemented starting in 2021 and will continue until the end of 2023, followed by other phases, which include all the remaining governorates.