FILE - Minister of Health and Population Hala Zayed FILE - Minister of Health and Population Hala Zayed

Decree urges private healthcare providers to indicate fees

Sun, Oct. 21, 2018
CAIRO - 21 October 2018: The Ministry of Health and Population informed private healthcare providers to indicate the fees on a banner and issue invoices for their patients along with medical reports bearing the institutions stamp.

The ministry granted the private medical institutions a 15 day deadline.

That comes in light of a decree issued by Minister Hala Zayed on Oct 15 to regulate the work system in the private healthcare sector. Health directorates in all 27 governorates will ensure that private medical institutions are abiding by the decree.

In December 2018, the House of Representatives passed the New Health Insurance Bill which is set to take effect over six stages. Each includes a number of governorates. The first stage, which was launched in July, comprises Port Said, Suez, Ismailia, North Sinai, and South Sinai; the second includes Aswan, Matrouh, Qena, Luxor and Red Sea; the third contains Beheira, Alexandria, Sohag, Kafr El-Sheik, Damietta; the fourth consists of Asyut, New Valley, Menya, Beni Sueif, and fayoum; the fifth embraces Daqahleya, Gharbeya, Sharkeya, and Menoufeya; and the sixth includes Cairo, Giza, and Qalyoubeya.

The sources of funding include subscription fees paid by citizens (main source), donations, taxes on cigarettes, and fees paid when issuing different licenses whether by citizens or businesses. The subscription fees will be as follows: subscribers will pay 5 percent of their income per month, with a maximum of 7 percent when including family members.

Egyptians working abroad and self-employed citizens must pay additional 3 percent per month for a non-working wife, and 1 percent per month for each child. In case of having more than two children, subscribers will pay 1.5 percent per month for every additional child.

Pensioners will pay only 2 percent of their monthly pension, and fees for included family members will be subject to the previous terms. Children seize to be subscribed as family members when they get employed, and in case of marriage for females.

Employers will pay 4 percent of the value of each employee's monthly salary with a minimum of LE 50. That fee covers treatment of work accidents. The state will pay 5 percent of the minimum income on behalf of the unprivileged. The numeric value of subscription fees will increase by 7 percent annually.

The following are the percentages of medical expenses paid by insurers when receiving different medical services. Insurers will pay 10 percent for all types of body scans, 20 percent for laboratory tests with a maximum of LE 1,000, and 7 percent for a hospital stay with a maximum of LE 1,500. Insurers wil pay 10 percent of the value of medicine, rising to 15 percent after 10 years of the law's enactment.

These numbers do not apply to medical services pertinent to chronic diseases and cancer. In other countries, the treatment of such diseases is totally covered by the insurance. That is not indicated in the bill but it will be in the executive regulations. A doctor's visit will cost the insurer LE 100. Insurers are reimbursed for charges paid in emergency services.

The current health insurance system covers 58 million citizens, including children, registered in the General Authority for the Health Insurance. However, actual beneficiaries who seek the service amount to 12.5 million only.

Beneficiaries can go to the 38 hospitals directly affiliated to the authority as well as 676 public, private, university, police and military hospitals contracting with the authority. The authority's annual budget is LE 6 billion ($337 million) and owns 61 ambulances serving citizens in all 27 governorates.

Free public health care will be repealed gradually in each stage the new system is introduced so that its budget, representing 3 percent, of the state's budget per the constitution will be directed to health insurance.
 
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