Compulsory health insurance will be introduced for Qatar expatriates from 2016

From 2016, new Social Medical Insurance scheme in Qatar will make it compulsory for all expatriates and visitors to have health insurance. There will be three separate approved packages: white-collar workers, blue-collar workers and domestic help. Employers must provide cover for basic health services.

The compulsory Social Medical Insurance scheme (Seha) only covers Qataris. The first phase, launched in July 2013, covered Qatari females aged 12 and above. The second phase launched in April 2014 included all Qatari citizens.

The third phase, postponed from 2015, will make it compulsory for all expatriates to have health insurances, from a yet to be announced date in 2016.

The big change is that instead of all cover being offered only by Seha, with private insurers locked out for a decade, the new options will only be offered by private health insurers, albeit on a very controlled basis. The real reason for this change may be that NHIC has struggled to operate Seha and control costs from some providers who saw a revenue opportunity, so would have faced challenges if it had to cover all expatriates too.

There will be three separate approved packages: white-collar workers, blue-collar workers and domestic help. How these are defined is still in the melting pot. Cover will apply to families of workers too.

Employers must provide cover for basic health services. These include preventative care, maternity, basic dental services and pharmaceutical services.

Employers will pay the cost of insurance for their employees and their dependents; the cost for either cannot be deducted from their salaries.

Employers must actually offer health insurance, as they are not allowed to offer cash to employees to buy their own cover.

The original rules said that employers could opt to provide more than the basic packages but it is not known if this will now apply.

Cover for Qataris will remain underwritten by Seha and administered by the National Health Insurance Company. Every treatment under Seha is offered at the same price in hospitals and clinics joining the scheme so bills cannot be manipulated. Each package of treatment or illnesses has a specific price. Seha sets prices, not the providers. The price schedule is revised periodically on the basis of data received through claims and expectations and changes in prices.

Cover for expatriates will be provided by competing private insurance companies, not by Seha. But insurers have to offer cover that is equivalent to the specified packages. As yet it is not clear if insurers will have the price set by the authorities, whether they can offer more than the minimum package, or if they are allowed choice on who they can accept or the terms they offer.

A Supreme Council of Health committee will set the packages, determine the price of each and set acceptance rules. So unless insurers can negotiate a compromise, they will lose control of cover, price and acceptance.

The Health Insurance Law provides that health insurance premiums shall be set without discrimination in respect of age, gender, previous health status or any other risk factors. This is on both basic and top up covers.

The law will also make insurance for visitors compulsory so that all travellers will need to prove that they have travel health insurance to cover emergency services only. Visitors will be responsible for their own health insurance premiums for the duration of their stay in Qatar and this will be paid as part of the visa application process. Pre-bought cover from any insurer is not accepted, as cover from Seha is built into the visa. There is nothing to stop people buying their own travel insurance, but they still have to pay for the Seha cover.

On new and existing compulsory health insurance the cost of treatment for each disease is fixed according to a package and all hospitals and clinics affiliated to the insurance system must offer the services at the same price. The costs are set by the Supreme Council of Health and not by the service providers. Two independent advisory bodies that are recognised internationally prepare the price schedule.

The provision of health insurance will be linked to the issuance and renewal of employee’s residence visas. So employers will not be able to obtain residence visas for expatriate employees until such health cover is in place.

Qatar has a population of 2.4 million, of whom 2 million are foreigners. There are suggestions that cover for Qataris will be far better than on any of the expatriate packages.

The ministry of health has suggested that the timing of the launch will coincide with the opening of new hospitals that only treat expatriate workers.