Assistant Secretary General-Policy Affairs at the Supreme Council of Health (SCH), Dr Faleh Mohamed Hussain Ali (centre), addressing the media yesterday. Also seen are, Manager, Health Financing and Insurance at SCH, Husein Reka (left), and CEO of AlKhaleej Takaful Group, Jassim Al Moftah. Salim Matramkot
DOHA: About 90,000 Qatari females aged above 12 will be covered in the first phase of the national health insurance scheme to be launched next month.
Initial service providers will include the Women’s Hospital of the Hamad Medical Corporation (HMC) and three private hospitals — Al Ahli, Al Emadi and Doha Clinic. Maternity, obstetrics, gynaecology and related services will be provided in the initial phase.
The second phase of the mandatory insurance scheme will begin in the first quarter of next year including the remaining segments of the Qatari population through a select provider network.
The third phase will see an expansion of the network including more private and public healthcare facilities.
White-collar expat workers and visitors will be included in the fourth phase that will begin in the first quarter of 2015.
Blue-collar workers — labourers — will be covered in the fifth and final phase and by the end of 2015, the entire population in Qatar, including visitors, is expected to have mandatory health cover.
“We have gone for a phased implementation because we can learn from each phase and make necessary amendments,” Dr Faleh Mohamed Hussain Ali, Assistant Secretary General for Policy Affairs at the Supreme Council of Health (SCH), told a news conference yesterday.
“We are starting from Qataris because it will be easier to manage this relatively small segment that is already supported by government funding.”
Another advantage of this strategy is that the population will be integrated into the scheme over a period of time. Officials clarified that contrary to some media reports, no one will be asked to leave the country because they are not immediately enrolled in the scheme.
The government will pay premiums for Qataris, while the employers are required to pay premiums for their expat employees and their families, including three children, according to the health insurance law issued last week. Employers are not allowed to deduct these premiums from their employees.
“We have decided the premium and have made an estimate about the expected cost of the project in the initial phase,” said Dr Ali, without giving details.
The scheme will use the Qatar ID card for identification and verification.
During the first phase (from July 2013 to the first quarter of 2014) Qatari women wishing to access maternity and gynaecology services can take an appointment directly from any hospital included in the network and identify themselves on their appointment date by showing their ID card.
The beneficiaries will not have to make any payments to the provider for services covered within the scheme.
They are also not required to register separately for the scheme. All they need to do to is identify themselves when they go to a provider using their Qatari ID card.
“We will soon announce details on how to avail of the scheme. There will be people to welcome Qatari women at the select hospitals and familiarise them with the scheme,” said Husein Reka, manager, health finance and insurance at SCH.
SCH also announced the launch of the National Health Insurance Company (NHIC) that is managing the insurance scheme. The NHIC is fully-owned by the government and managed by an executive team, reporting to a board of directors.
The board will comprise representatives from SCH, the Ministries of Finance, Labour, Interior, the Central Municipal Council and two representatives from the private business sector.
Appointment of the Third Party Administrator (TPA) for the scheme was also announced yesterday.
The TPA will administer the daily operations of the scheme on behalf of the National Health Insurance Company, similar to the way such health insurance systems are operated worldwide.
AlKhaleej Takaful was selected after an extensive tender earlier in 2012.
The AlKhaleej offer brings the Qatari AlKhaleej Takaful Group, together with global insurance organisation Aetna International and GlobeMed.
“The establishment of the NHIC and the appointment of the TPA today marks another major milestone on the road to launching the scheme,” said Dr Faleh.
AlKhaleej Takaful will establish the infrastructure for connecting beneficiaries and providers with the National Health Insurance Company. This includes the claims management systems and call centre.
“As a Qatari national company, Alkhaleej Takaful Group is extremely proud to be part of this prestigious project,” said Jassim Al Moftah, CEO of AlKhaleej Takaful Group.
The insurance scheme also includes introduction of the mandatory inpatient coding system (ICD 10 AM) and its training for administrators in Qatari hospitals.
The Qatari Outpatient Classification system the Minimum Data Set are also part of this allowing coding on the outpatient front and systematic data capturing and reporting.
Information about the scheme has been made available on the SCH website at www.sch.gov.qa.
SCH is also planning an advertising campaign to educate people about the scheme and will set up booths at certain locations for this purpose. The Peninsula