The State Agency on Mandatory Health Insurance under the Cabinet of Ministers of the Republic of Azerbaijan was established on 27 December 2007 (the Order of the President of the Republic of Azerbaijan No. 2592). It started functioning on 15 February 2016 and became a public legal entity named the State Agency on Mandatory Health Insurance (hereinafter the Agency) on 24 November 2016 (the Decrees of the President of the Republic of Azerbaijan No. 765 and 1125 respectively).
The Agency implements mandatory health insurance through accumulating revenues to finance medical services within benefit package and acting as purchaser of these services.
The Agency goals are the following:
- To involve the public in mandatory health insurance;
- To accumulate revenues to finance medical services within benefit package;
- To take measures to improve quality of medical services and to ensure accessibility of these services to the public;
- To protect rights and legal interests of the insured;
- To ensure efficient spending of raised revenues and making insurance payments on time.
The Agency operates in the following directions:
- Involvement in developing a single policy on mandatory health insurance and to ensure implementation of this policy;
- Arranging mandatory health insurance for the public and ensuring financial sustainability of this insurance;
- Providing the public with equal conditions to use medical services within mandatory health insurance;
- Taking measures to ensure accessibility of mandatory health insurance for everyone and to improve quality and efficiency of medical services to protect the health of the population;
- Ensuring further development of mandatory health insurance.
Mandatory health insurance has been implementing as a pilot scheme in Mingachevir and Yevlakh (the Decree of the President of the Republic of Azerbaijan No. 1127 of 29 November 2016) and Aghash (the Decree of the President of the Republic of Azerbaijan No. 1830 of 16 February 2018) providing 1829 medical services within a benefit package. Its implementation throughout the country is planned to be gradual.
There are also 1186 medical services (exclusions) not covered by the benefit package. To use these service, citizens must make official payments.
Those entitled to benefit from the pilot scheme are the following:
- Citizens of the Republic of Azerbaijan registered in Mingachevir, Yevlakh or Agdash in accordance with the Law of the Republic of Azerbaijan On Registration of Residence and Presence, and foreigners or stateless persons temporarily or permanently residing in Mingachevir, Yevlakh or Agdash in accordance with the Migration Code of the Republic of Azerbaijan;
- Internally displaced persons settled in Mingachevir, Yevlakh or Agdash.
Medical services provided under mandatory health insurance are the following:
- Emergency (including ambulance service);
- Primary healthcare (family physician);
- Outpatient services;
- Inpatient services;
- Instrumental diagnostics (USI, CT, MRT, etc.);
- Pregnancy and delivery;
- Urgent vaccinations (anti-rabic, anti-tetanus, anti-snake venom, etc.);
- Scheduled child vaccinations;
- Surgeries (including expensive heart surgeries, cochlear implantations, etc.);
- Specialised continuing healthcare.