Tuesday, June 18, 2024

Iran Health Insurance Organization Expands Budget and Services for Special Diseases Support Fund

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The CEO of the Iran Health Insurance Organization announced that the budget for the Special and Hard-to-Treat Disease Support Fund has increased to 9 trillion rials this year. New dental service packages for 10 specific diseases have been developed and will be uploaded to the system. In a press conference held at the central headquarters of the organization, Mohammad Mehdi Nasehi highlighted that the fund’s budget was 5 trillion rials in its founding year, reached 7 trillion rials last year, and has now increased to 9 trillion rials in its second year.

He noted that the fund has become more stable and robust over the past two years, reflecting the government’s and the Ministry of Health’s commitment to expanding the support network for patients with special diseases. Collaboration between the Ministry of Health’s Treatment Deputy and the Health Insurance Organization over the past year and a half has led to the design of the fund’s main structure and the injection of sustainable resources into it through the national budget.

Nasehi added that currently, the fund has developed service packages for 107 disease groups and uploaded them to the system. Additional packages for other specific diseases will gradually be developed and announced by the Treatment Deputy of the Ministry of Health. The CEO stated that service packages for 53 specific diseases have already been uploaded to the system. This year, packages for 11 new diseases have been developed, with six ready to be uploaded.

New Dental Service Packages for 10 Diseases Announced by Iran Health Insurance Organization

Nasehi announced the development of dental service packages for 10 specific diseases, which will be uploaded to the system. These services will be available for patients with hemophilia, thalassemia, multiple sclerosis (MS), dialysis, metabolic disorders, epidermolysis bullosa (butterfly disease), various transplants, different cancers, mental disorders, and autism. He added that hospitalization costs for transplant patients and cochlear implants are also covered by the health insurance. Free hepatitis C services have been uploaded to the system, and additional services for patients with SMA and hemophilia are being completed.

Nasehi pointed out that 2 million patients covered by Social Security have been marked in the Special and Hard-to-Treat Disease Support Fund system. All insured individuals should be able to use the insurance services, as the health insurance is universal and not limited to a specific insurance organization.

The Health Insurance Organization’s CEO also mentioned that the diseases covered by this fund include thalassemia, hemophilia, chronic kidney failure, MS, dialysis (hemodialysis and peritoneal dialysis), hepatitis C, various cancers, autism spectrum disorder in children, chronic mental disorders, transplants, brain conditions, diabetes, Parkinson’s surgery, epilepsy, severe and profound hearing impairments, cochlear implants, muscular dystrophy, and 21 metabolic diseases.

Health Insurance

Iran Health Insurance Organization Expands Coverage for Drugs and Services in 2024

In the pharmaceutical sector, major costs for special patients are covered, and drugs for diseases like SMA and cancer are fully covered. For some diseases, such as hemophilia, patients only pay a half-percent co-pay. Additionally, 25% of the cost of prosthetic limbs due to diabetes-related amputations is covered by the health insurance. Important paraclinical services like PET scans for cancer diagnosis and radiotherapy are also included in the fund’s coverage.

Nasehi stated that in 2024, six new service packages were introduced, including cochlear implants and services for autism patients over 12 years old, which are being finalized by the Ministry of Health’s Treatment Deputy.

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He also mentioned that the share of cancer patients’ payments for radiotherapy services in public centers has been made free and reduced in private health insurance centers. By the end of 2023, there had been over 6.6 million visits to the health insurance by special patients. Nasehi emphasized that significant progress has been made in preventing new thalassemia births over the past decades, which is crucial for managing the disease.

Thalassemia and MS Patients Receive Enhanced Support and Services from Special Disease Fund

He concluded by stating that thalassemia has been a priority for support from the beginning, with free services provided. With the establishment of the health insurance, this support has increased. Additionally, 26 new service codes, including radiology, bone density measurement, rehabilitation, psychology, and dentistry services for thalassemia patients, have been added to ensure all necessary services are covered.

Regarding MS patients, both foreign and domestic medications are available. For 95% of the 1,000 MS patients allergic to domestic drugs, branded medications have been provided. This policy will be applied to all special patients.

In conclusion, Nasehi highlighted the importance of the 1666 helpline for informing the public about special diseases and the services of the Special Disease Support Fund. This helpline provides information about the insurance coverage of the fund for special patients. The most expensive injectable insulin and the widely used diabetic drug metformin are under the fund’s coverage, with diabetes and hypertension being the most costly diseases covered.


Resource: Tasnim News Agency, May 07, 2024

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