The Cabinet ratified proposals in five critical areas approved by the Supreme Council of Health Insurance, said Dr. Mohammad Aqajani, deputy minister of health.
Accordingly, drugs for treatment of lung disease, hypertension, multiple sclerosis, scleroderma and lymphoma as well as critical drugs used in intensive care units (ICU) of hospitals are now under insurance coverage. The drugs are listed in the country’s pharmacopoeia, ISNA reported.
Further, insurance companies will be allowed to sign six-month temporary contracts with obstetrics centers in three provinces of Isfahan, Ardabil and Golestan for prenatal care to pregnant women, he said.
Providing insurance to specialized sports medical services was approved and for the first time sports-medical services will be under coverage of insurance organizations.
Henceforth, paraclinical services, imaging and laboratory services will also be covered by insurance. New tariffs were fixed for medical services in public hospitals at two-thirds the tariffs of private medical centers, and outpatient services will cost 30% less.
Healthcare services are supported through several public and non-public insurance schemes. Insurance schemes have developed in parallel over time. Access to services and choice of provider is determined largely by the type of insurance coverage. There are several insurers each offering a different package, co-payments and referral and counter-referral systems, Aqajani added.
More than 90% of Iranians are under the coverage of at least one kind of health insurance.
The non-government Social Security Organization (SSO) is the largest health insurer. All employed citizens except government employees and military service people, contribute to and receive benefits from the SSO, which owns and operates several hospitals in urban areas. Medical services in institutions run by SSO are offered either free of charge or at very low cost for policy holders. Nearly 40 million Iranians are under the SSO umbrella. It also covers retirees.
The public sector Iran Health (Salamat) Insurance Organization was established in 2014 to cover up to 90% of a patient’s medical bills in state hospitals. It provides coverage to those lacking health insurance, such as women heads of households, the unemployed, the poor and disabled, who account for over 10 million of the population.
