The national health insurance provider, Aasandha Company Limited, has announced changes its outpatient services to prioritise private insurance schemes. The company stated that this initiative aims to ensure the sustainable provision of services under the Aasandha Scheme, in accordance with the decision made by the National Social Protection Agency (NSPA). NSPA stated that the changes will prioritise private insurance in billing individuals who seek outpatient healthcare services, starting November 1. This change is part of the government’s broader efforts to reform and enhance the Aasandha scheme. The NSPA clarified that individuals whose private insurance does not cover specific services or has expired will still receive coverage under Aasandha. The changes being implemented under this initiative are as follows: – If an individual seeking healthcare services has a private insurance, it should be confirmed before preparing the service memo, and the private insurance must be utilised until the coverage limit is reached. – If the medical service can be covered by the private insurance, the service must be provided through the private insurance scheme – Private insurance schemes will be prioritised in billing individuals seeking outpatient services – If the private insurance does not cover specific healthcare services which are covered by Aasandha, the individual will receive coverage under Aasandha – If the private insurance limit is reached, and if the healthcare service can be covered by Aasandha, the individual will receive coverage under Aasandha – If an individual, whose private insurance does not exhaust the coverage limit related to the service sought, Aasandha portal must be utilised in providing services and Vinavi portal must be utilised to prepare medical prescriptions. Furthermore, Aasandha Company stated that the health insurance schemes under Maldives Police Service (MPS) and the Maldives National Defence Force (MNDF), are not considered as private insurances. Moreover, billing for individuals seeking inpatient services will be continued as before, under the Aasandha scheme. Additional information on these changes can be sought by contacting the call centre of Aasandha Company. It has also urged individuals to report any instances in which services are provided against these guidelines.
