His Excellency Dr Mohamed Muizzu, President of the Republic of Maldives, announced on Monday that Aasandha, the national social health insurance scheme, will move to an income based model from next month, ending uniform full coverage for the country’s highest earners.
Speaking at a press briefing at the President’s Office, the President said technical experts and industry professionals had advised that providing identical coverage to every resident regardless of income is not the most appropriate way to run the scheme.
Under the revised policy, individuals earning a monthly salary above MVR 60,000 will no longer receive 100 percent coverage. Those within that income bracket will instead access Aasandha benefits through a co-payment or pre-payment arrangement. Everyone earning below the threshold remains on full coverage.
What the Change Is Expected to Save
The President said the reform is projected to save the State MVR 287 million a year, money that will be redirected toward other public services and national development priorities. Aasandha expenditure is expected to begin declining this year, though the full fiscal effect will only be visible over the course of the coming year.
Operational details, including how income will be verified and what the co-payment and pre-payment arrangements will look like in practice, are to be announced by the relevant authorities in due course.
A Scheme Under Sustained Cost Pressure
Aasandha has been in place since January 2012 and is one of the most widely used public services in the country, covering every Maldivian citizen for treatment at home and at designated facilities abroad. Its reach has also made it one of the fastest growing lines in the national budget, and spending has consistently run ahead of the allocations set for it.
That trajectory has framed successive reviews of how the scheme is funded and how its benefits are distributed. Moving to an income tiered structure places the Maldives alongside a number of health systems that ask higher earners to carry part of the cost of their own care while protecting full entitlement for everyone else.
What to Watch Next
Three questions will shape how the reform lands. The first is the design of the co-payment itself, since the size and structure of the contribution will determine whether higher earners stay inside the scheme or look to private cover instead. The second is verification, because salary is straightforward for employees on payroll and less so for business owners and the self employed. The third is administration, as the Aasandha Company and health facilities will need systems capable of applying two coverage tiers at the point of service without slowing treatment.
With implementation set for next month, the detailed policy that follows will matter as much as the announcement itself.
