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Saint Yared Health Maintenance Plan

About the Product(s)

Countries of Operation: Ethiopia
 
Product status: Active
 
Institutional Model: Community-based health insurance/mutuelle
 
Type of Coverage: Voluntary
 
Type of Policy: Individual + family policy
 
Provider of health services: Private providers
 

Depending on the benefit structure and premium of the plan, policy holders and beneficiaries are able to access in- and/or out-patient services as Saint Yared Higher Clinic as the need arises.

 
Benefits and services covered: Hospitalization
 

There are three types of plans. The Silver Plan provides covered individuals with access to basic primary care services, referral to specialty services and radiological services. The Gold Plan provides the same services provide under the Silver Plan plus access to surgical services at the Saint Yared Higher Clinic. The Diamond Plan is the most comprehensive and expensive plan. In addition to the benefits provided under the Gold Plan, the Diamond Plan offers a 40% discount on all medications listed in the formulary of the Saint Yared Higher Clinic.

 
Premium Amount: It is required that the full annual fee be paid in advance at the beginning of the year. A 5% discount applies in cases where coverage is purchased for a family of 3 or more persons.
 
Frequency of premium payment: Full payment upfront