Table 2 Main features of health insurance schemes in Iran (2018)

Affiliation

Governmental

Governmental

Governmental

Governmental

Public Non-Governmental

Governmental

Who is insured?

Government employees

Residents in rural areas and cities less than 20.000 population

Self-employed

Students, disables, families with injured persons during the war, some professional associations and similar

Employees of the formal private sectors, self-employed and voluntary contributors

Military personnel and their families

Membership

Obligatory

Voluntary

Voluntary

Voluntary

Obligatory

Obligatory

Population size (2018)

5.413.088

19.969.227

14.441.544

1.438.973

43.475.548 (2019)

Not available

Contribution rate (2017)

7% of the wage (2%, 2% and 3% paid by the employee, employer, and government respectively)

7% of the minimum wage (paid by the government)

Fixed premium (400,000 Rial per month, 100% paid by the government)

7% of the minimum wage (100% paid by the government)

30% of which 9% is for health benefits package (2%, 6% and 1% paid by the worker, employer, and government respectively)

7% of the wage (2%, 2.5% and 2.5% paid by the employee, employer, and government respectively), An extra mandatory fixed amount is also deducted for supplementary coverage which is paid by the employees

Per capita expenditures per year (2018)²⁶

480,968 R*

277.565 R

371,580 R

573.173 R

431.719 (2019) R

Not available

User charges

10 to 30% of in patient and out-patients health services respectively in the public hospitals based on public medical tariffs. Also, the gap between private and public medical tariffs in private centres

10 to 30%

10 to 30%

10 to 30%

10 to 30% of in patient and out-patients health services respectively based on public medical tariffs. Also, the gap between private and public tariffs in private centres. No copayment in SSO’s hospitals and health centres