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CBHI (Community Based Health Insurance) Programme

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CBHI (Community-Based Health Insurance) Program

Program Summary

Community-Based Health Insurance (CBHI) is part of the health insurance system that reaches out to the part of communities that is involved in the informal economy sector in rural, urban, and pastoralist areas in most parts of the country. Currently, Community-Based Health Insurance (CBHI) is being implemented in 834 woredas and covered about 9,596,633 Households and about (43 million) CBHI members with beneficiaries. CBHI members also include about provided by the government as a subsidy to poorer community member-Indigents/people who could not afford to contribute. CBHI financing comes through premiums gathered by community members that cover all health and curative services for families as well as through a 2,439,495 HHs (24%) subsidy provided by the government.

Program Objective

The objectives of Ethiopia’s Community-Based Health Insurance (CBHI) scheme are

  • enhancing access to health care, reducing out-of-pocket expenditure (OOP), mobilizing financial resources
  • enhancing the quality of health care.
  • To provide financial risk protection to citizens and improve access to health services.

 

CBHI program coverage by region (2022)

 

Workplace TigrayProgram AfarProgram AmharaProgram BenshangulProgram GambelaProgram SouthWestProgram SNNRPProgram SidamaProgram SomaliProgram OromiaProgram HarariProgram DiredawaProgram AddisAbabaProgram

               Total

9,596,633 HHs

 Entitlement

The type of entitlements provided within this program includes.

  • Essential health services and other critical curative services.
  • Services from health facilities that have entered contracts with the Health Insurance agency
  • in- and outpatient care,
  • delivery services,
  • surgical services, and diagnostic tests,
  • Generic drugs are included in the drug list of the Health Insurance Agency and prescribed by medical practitioners.
  • The benefits package covers all in- and outpatient services except chronic dialysis, eyeglasses, false teeth and cosmetic procedures, and treatment outside Ethiopia.

 

Type of Client and Coverage

  • CBHI Contributors 8,157,138HHs
  • Indigents 2,439,495

 

 Eligibility

  • Voluntary-membership Contribution
    • Contributing 240 ETB (US$ 4.6) per household per annum for rural beneficiaries
    • Contributing 350 Birr (US$ 6.6) per household per annum for urban beneficiaries
    • Contributing 500 ETB (US$9.5) per household per annum for bigger city residents
    • Indigents (those who were registered in the CBHI system but could not afford it since their income is below the national poverty line.

Prevailing dollar exchange rate in the month of November 2022

Moreover, the beneficiary is excepted to fulfill at least two of the criteria to be eligible.

Click on http://www.socialprotection.gov.et/ for more information

 

Available Documents

CBHI Members Registration

Ethiopian Health Insurance Agency ehiagov.com  

CBHI Members with cards