Mohammad Mehdi Nasiri, CEO of the Health Insurance Organization of Iran, announced the financial challenges of this organization and the increase in insurance coverage for the elderly at a press conference during Health Insurance Week. He pointed out the rising treatment costs and the difficulties in securing financial resources, stating: "In the past four and a half years, payments to healthcare centers were made on time, but since the second half of 1403, due to the disruption of balance between resources and expenditures, payments have been delayed."
Financial Challenges and Apologies to Healthcare Centers
Nasiri stated that the Health Insurance Organization pays more than 8 trillion tomans monthly to contracted institutions and centers, adding: "This year, we have tried, despite resource limitations, to pay between 50 to 60 percent of the registered claims of healthcare centers immediately after the end of each month so that these centers do not face serious problems." He also emphasized that the actual costs of the organization are now nearly double the amount paid monthly, and the resources from premiums and government credits do not cover all obligations.
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Increase in Insurance Coverage and Support for Special Patients
The CEO of the Health Insurance Organization explained the organization's overdue claims, stating that 85 trillion tomans have been allocated in the form of shares to settle debts. Nasiri also referred to the approval of increased insurance coverage for certain dental services, saying: "According to the new resolution, 70 percent of the costs of certain dental services in public and private non-governmental centers will be covered by basic insurance."
He also discussed the performance of the fund supporting special and chronic patients, stating: "This fund has managed to reduce direct payments from patients by about 30 trillion tomans over the past two and a half years. In collaboration with the Treatment Deputy of the Ministry of Health and other insurers, various groups of chronic and costly diseases have been identified." Nasiri criticized the calculation of this fund's credit as part of the overall resources of the Health Insurance Organization, adding: "This fund belongs to all people and insured individuals in the country and should not be calculated as an increase in the dedicated budget of health insurance."
He concluded by expressing hope for cooperation from the government and the Planning and Budget Organization, calling for expedited provision of the necessary resources for health insurance to maintain insurance coverage for the people.
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