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Bahrain Fails to Launch IPMI for Expats

In this iPMI Global Insights article, iPMI report author, Ian Youngman reports on iPMI in Bahrain and takes a deep dive into iPMI in the region. According to Youngman, and contrary to other "media" outlets, once again Bahrain has missed its own deadlines for launching compulsory IPMI for expats. Bahrain may also miss the deadlines for compulsory insurance for locals.

Ian Youngman is a writer and researcher specialising in insurance. He writes regularly for a variety of magazines, newsletters, and on-line services. He publishes a range of market reports, and undertakes research for companies. To read his latest report, International Health Insurance 2023, please click here, or visit the REPORTS section of iPMI Global.

  • Bahrain has delayed the soft launch for the expatriate market of a mandatory Health Insurance Law.
  • The Ministry of Health was due to start applying the mandatory health insurance to foreigners.
  • Despite more statements from the Ministry of Health that it will begin in Q3 2023, by late October 2023 nothing has happened.
  • No new date for the soft launch has been suggested.
  • By 2024 it will be fully operational-the ministry claims.
  • Hakeem is a comprehensive insurance programme for expats.
  • The compulsory insurance scheme for foreigners and residents aims to transform a culture of dependence on government health services into a comprehensive and self-financed health insurance system.
  • According to official data, the new health insurance will cover 720,000 foreigners residing in Bahrain.
  • Most expats are currently registered in the basic cover system of the Ministry of Health under which they pay an annual fee of BHD72 each.
  • When the full mandatory health insurance scheme is implemented, employers will be obligated to insure the foreign worker and his family with licensed insurance companies in Bahrain.
  • The Hakeem programme includes two packages – one that is mandatory and the other optional – will be funded by the employer or sponsor and will be made available in government and private facilities.
  • The mandatory package is for expat workers of a specific age and includes primary healthcare and emergency services as well as secondary healthcare services upon referral by a family physician.
  • It does not include maternity room services, cosmetic procedures and there is a cap for spending.
  • In the optional package, expats have the right to sign up with private insurance companies, provided that the benefit package is inclusive of all the services provided in the mandatory package.
  • Insurance companies will provide the compulsory and optional health packages to expat residents.
  • International insurers are allowed to sell insurance within the kingdom without a local partner.
  • The Health Insurance Law allows standalone health insurance from foreign insurers, but each insurer has to get authorisation.
  • Insurers that meet certain criteria will be approved to offer the mandatory health insurance.

Analysis

  • Bahrain has a terrible track record on moving from vague plans, to detailed plans, to actually implementing laws and systems.
  • This is now running four years behind schedule.
  • Bahrain has seen double-figure growth for its private medical insurance industry over the last six months, according to latest figures from the Central Bank of Bahrain (CBB). 
  • Premiums increased from BD 46.78m (£100m) in the six months ended 30 June 2022 to BD 52.31m (£112m) in the same period of 2023. That represented an increase of about 12%. 
  • Medical insurance is the largest in terms of total gross premiums which -35% of the total gross premiums written in Bahrain for the period ended 30 June 2023. 
  • The mandatory health insurance scheme is forecast to at gross premium oft BHD50m (US$133m) for insurers in 2023-24 premiums for medical insurance.
  • The insurance sector in the kingdom provides a fertile ground for local and international companies to innovate and drive transformative change to provide insurance solutions to meet the evolving needs of individuals and companies in light of the digital development in the financial sector in general.
  • To improve local healthcare Bahrain needs international investment.
  • US-Bahrain Healthcare Partnership Forum seeks engagement, high-level dialogue through a series of expert-led panel discussions, and opportunities for networking to bolster cooperation, direct contact and business building between Bahraini and US counterparts. 
  • One area it is exploring is care for Bahraini patients inside and outside the country.
  • One long standing healthcare collaboration between the USA and Bahrain is the American Mission Hospital, formerly known as the Mason Memorial Hospital, as well as the recently launched King Hamad - American Mission Hospital in A'ali, a cutting-edge facility that stands as one of the most advanced healthcare institutions in Bahrain and the Gulf region.
  • US healthcare organisations looking at Bahrain include Atrium Health, Baylor St Luke's Medical Centre, Cedars Sinai, Children’s National, Cleveland Clinic, CommonSpirit Health, Cook Children's, Indiana University Health, Johns Hopkins Medicine, The James Cancer Hospital at The Ohio State University, UChicago Medicine and UCLA Health.
  • The deadlines for full launch are not revealed.

What Next?

  • The insurance sector in Bahrain is undergoing a transformative journey with the implementation of the international standard IFRS17 and many other initiatives launched by the CBB in cooperation with several entities.
  • Bahrain's National Health Insurance Scheme for locals is being brought in in 2024- perhaps.
  • Once it is launched, Bahrainis will continue to be eligible for free services at public health facilities.
  • The mandatory health insurance scheme will be implemented to citizens in 2024.
  • There will be a soft launch in early 2024 and a full launch in late 2024 of Sehati.
  • The Health Insurance Fund (Shifa) will provide citizens with two packages: the mandatory health package and the optional health package.
  • Under the health insurance law, the government pays the contributions on behalf of citizens to cover the benefits in the mandatory health package for citizens, which include access to preventive, curative and rehabilitative services and medical examinations.
  • Insurers are not involved in the mandatory or optional package for citizens.
  • The national health insurance programme includes the application of a number of health information systems, including a unified electronic medical file for each individual that will enable the attending physician from any licensed health institution in the government and private sectors to view the medical file to provide the appropriate treatment.
  • The systems will integrate the health, financial and administrative information of each patient.
  • The Health Insurance Fund will be used to generate income and administer it to achieve the on-going financial stability and sustainability of the health system service providers to obtain national and international accreditation.
  • The services that will be provided for Bahrainis include medical check-ups, diagnosis, treatment and primary healthcare; laboratory examinations and X-rays; operations; maternity and child care; hospitalisation for treatment and rehabilitation; dentistry excluding cosmetic procedures; psychiatric treatment and consultation; physiotherapy; In Vitro Fertilisation (IVF); liposuction; cosmetic surgery; medicines required for treatment; medical aid devices; cost of one travel companion if the case requires it; ambulance services; long hospitalisation; chronic illnesses; and any services added later by the SCH.
  • Bahrainis will be able to seek these services for free at government-owned medical facilities.
  • Those choosing private sector hospitals or clinics will have to pay no more than 40 % of the cost, with the government picking up the balance.
  • GCC citizens, expatriates married to Bahrainis and children of Bahraini mothers will receive the same benefits.
  • Bahrain Defence Force personnel are not included, as for the time being BDF has opted out of the scheme and will continue to offer medical treatment in BDF run hospitals.
  • The law requires mandatory health insurance for everyone not excluded.
  • This is to be achieved through payment of insurance contributions into the fund, which will provide insurance cover through a mechanism where insurers licensed under the law pay beneficiaries' valid claims.
  • Bahraini citizens are entitled to receive free treatment without limit at all government medical facilities under Sehati and the compulsory services will include comprehensive primary healthcare, inpatient-outpatient and accidents and emergency services in Bahrain; and conditional in-vitro fertilisation, medicines, all types of medical tests and treatment abroad, if required.
  • The national health insurance programme includes the application of a number of health information systems, including a unified electronic medical file for each individual, which will enable the attending physician from any licensed health institution in the government and private sectors to view the medical file to provide the appropriate treatment.
  • The systems will integrate the health, financial and administrative information of each patient.
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