This regulation is issued to implement Proclamation No. 1273/2022 Community-Based Health Insurance Proclamation. It establishes the framework for managing health insurance pools and reserve funds (Sections 3-6), outlines membership and contribution procedures (Sections 7-9), and details provider payment mechanisms (Section 10). It also addresses fund management, financial deficit coverage (Sections 11-13), and miscellaneous provisions such as co-payment and data management (Sections 14-20).
This Proclamation provides the legal framework for the Community Based Health Insurance System.
The Insurance Act of 2021 establishes the National Insurance Commission, and provides for the regulation and supervision of the insurance market and related matters.
The Proclamation establishes a mandatory health insurance scheme for pensioners, employees and members of their families in Ethiopia.
The National Health Insurance Act was adopted to establish a National Health Insurance Authority to implement a National Health Insurance Scheme, establish a National Health Insurance Fund to pay for the cost of health care services to members of the Scheme, establish private health insurance schemes, and to provide for related matters.
The Law establishes a mandatory health insurance scheme for pensioners, employees and members of their families in Ethiopia.
The National Health Insurance Regulations of 2004 govern the registration, management, and oversight of health insurance schemes licensed under the Health Insurance Act of 2003, detailing requirements for licensing conditions, and fees. They mandate non-discrimination, set minimum benefit standards, and outline procedures for interim management and the accreditation of healthcare facilities.