The comprehensive health insurance system began in July 2021 in Port Said Governorate and is being gradually implemented across all Egyptian governorates to include all citizens. It covers all necessary medical services such as laboratory tests, radiology, medications, dental treatment, cancer treatment, emergencies, and surgeries.
Health insurance in Egypt has become indispensable. Private companies and government sectors in Egypt now emphasize the importance of health insurance to protect their employees. When a family member faces a health crisis, numerous procedures are needed to ensure their well-being, and comprehensive health insurance provides full coverage for all their requirements.
Objectives of Comprehensive Health Insurance in Egypt
- Ensure access to integrated healthcare for all citizens of the Arab Republic of Egypt fairly and equally, including children, informal sector workers, and the elderly.
- Provide high-quality health services that satisfy all citizens, gradually covering all regions and governorates.
- Continuous training for doctors and nurses to improve their medical skills and equipping hospitals with the latest medical devices and health centers.
- Providing hotlines to receive citizen complaints.
- Establishing a funding system that includes monthly or annual contributions suitable to the individual's income, and obtaining additional financial support from companies and international institutions.
The comprehensive health insurance system focuses on justice and quality. It is funded through family subscriptions, with the public treasury covering costs for families unable to afford it. The system adapts to future changes and challenges.
Covers all health services including diagnosis, treatment, family healthcare, emergency medical services, and hospitalization.
Limited to certain preventive and diagnostic services.
In short, comprehensive health insurance provides full coverage for all health services, while traditional health insurance offers limited coverage for specific health services.
Subscription Fees for Comprehensive Health Insurance
The subscription fee for comprehensive health insurance in Egypt varies based on several factors:
- The fee is determined as a percentage of the individual's or family's income for those working in the public and private sectors.
1. Employees pay a percentage of their salary, and the employer pays another percentage. For example, an employee pays about 1% of their salary, 3% of the wife's income if she works, and the employer pays 3%. If the wife does not work, 1% of the husband's income is paid, and 1% for each child, with the employer paying an additional 3% of the employee's salary.
2. Pensioners pay about 2% of their pension.
3. The public treasury covers subscriptions for families unable to afford them according to specific standards and regulations determined by a decree from the Prime Minister.
4. Workers with irregular incomes pay a fixed subscription ranging from 50-100 EGP monthly based on their income.
- The subscription is automatically deducted from the employee's salary in both the public and private sectors. Individuals working in the informal sector can pay at health centers or through electronic payment.
How to Subscribe to Comprehensive Health Insurance
1. Visit the nearest authorized health unit or medical center.
2. Submit the required documents (national ID card, children's birth certificates, proof of family income).
3. Register with the relevant employee at the unit or center by entering the family’s data.
4. Pay the subscription, which is determined based on family income after registration.
After completing these steps, you can access health services at authorized health units and hospitals.
Is Enrollment in Health Insurance Mandatory?
Comprehensive health insurance is mandatory for all citizens to provide comprehensive and fair healthcare. The aim of making it mandatory is to ensure comprehensive health coverage for all.
Benefits of Comprehensive Health Insurance
Comprehensive health insurance covers all therapeutic health services, first aid, emergency services, reproductive health services, and diagnostic services such as periodic examinations and laboratory tests. It includes a children's vaccination program.
Citizens bear only 5% of the cost of surgeries, 10% of the cost of laboratory tests and radiology, and 10% of the cost of monthly medications and treatments. The state exempts those unable to pay, as well as individuals with chronic diseases and cancer.
Comprehensive Health Insurance Law
The Comprehensive Health Insurance Law in Egypt defines the comprehensive health insurance system's principles, regulations, and procedures. The law aims to provide health services to all citizens fairly and includes several articles:
1. Defining the system's objectives and guiding principles.
2. Identifying the entities responsible for implementing and managing the system.
3. Specifying the conditions for subscribing to the system.
4. Defining the health services covered.
5. Specifying the rights and duties of citizens who subscribe to the system.
6. Ensuring the quality of provided health services.
7. Determining financial or legal penalties for violations committed within the system's framework.
Governorates Covered by Comprehensive Health Insurance
The first governorate to implement the comprehensive health insurance system was Port Said, with expansion to other governorates including:
- Luxor
- Ismailia
- South Sinai
- Aswan
The system is gradually expanding to cover all governorates of the Arab Republic of Egypt, providing health protection for all citizens.