The Heavy Cost of Treatment for Afghan Migrants / Free Insurance Only for Eligible Groups / The Government's Responsibility in Treatment Support

According to KhabarOnline, meanwhile, residence status, possession of valid documents and the ability to pay insurance premiums play an important role in the possibility of using treatment support.

 Hospital treatment counts as a heavy cost for many families; but for Afghan migrants who have no insurance and whose income comes from labor and low-paying jobs, this cost can become a serious obstacle to accessing medical services. Meanwhile, an important question is raised about how the treatment costs of Afghan nationals residing in Iran are calculated. “Should a person who has lived in Iran for years, was even born in Iran, or works to provide for his family, be assessed by the same criteria considered for a health tourist?

Jamaran wrote: A review of news published in domestic media, statements by Health Insurance officials and information from international bodies shows that the insurance status of migrants is not uniform and that part of the vulnerable refugees enjoy insurance support; however, the cost of insurance, residence conditions and financial limitations remain in question. Clarifying the legal tariffs, how hospital bills are calculated and the status of migrants without insurance coverage can help answer more precisely about one of the most sensitive issues in migrants' lives in Iran. 

The difference between a resident patient and a health tourist 

One of the main questions on the cost of treatment for Afghan migrants is the difference between a person who travels to Iran to receive medical services and a person who has lived in Iran for years and goes to a hospital to treat his illness. “Health tourism” refers to people traveling to another country to receive medical services. In contrast, many Afghan migrants residing in Iran are present in this country to work, live and provide for their families. Some of them have lived in Iran for years and were even born right here; however, their residence and insurance status differs seriously from that of Iranian citizens. 

In such circumstances, the question arises: if an uninsured migrant goes to a hospital for hospitalization, surgery or specialized services, on what tariff basis are his service costs calculated? Is the mere lack of insurance the basis for applying a different tariff, or are there other regulations regarding residence status and the type of medical service? 

To answer this question, three topics must be distinguished: the full cost of medical services for an uninsured person, the premium a person pays to enjoy insurance coverage, and the tariff a hospital sets for providing services to different groups of patients. These three topics are related to one another, but they are not the same. 

95,000 vulnerable foreign nationals covered by health insurance 

Tasnim News Agency, in a report in Farvardin 1403 (March–April 2024) titled “The UN pays the insurance premiums of vulnerable nationals,” citing Jamshid Shayanfar, then director general of insurance and resource attraction of Iran's Health Insurance Organization, announced that 95,000 vulnerable foreign nationals have been covered by basic health insurance and their premiums are funded by the United Nations High Commissioner for Refugees. 

This news shows that for part of the vulnerable foreign nationals, a support mechanism has existed in the field of health insurance; a mechanism whose goal is to reduce the financial obstacles to accessing medical services. However, the announced figure alone does not specify how many of all Afghan migrants residing in Iran lack insurance, how many cannot afford the premiums, and how much of their hospital costs are covered from support resources. Moreover, this number (95,000 people) is far from the total number of Afghan migrants residing in Iran.

Mohammad Mahdi Nasehi, CEO of Iran's Health Insurance Organization, reported a difference between the health insurance premiums of Amayesh card holders and Iranian citizens. According to this report, the announced premium for Amayesh card holders was stated to be 80 percent higher than that of Iranian citizens. The same report stated that fewer than 100,000 migrants holding Amayesh cards, with the support of the UN High Commissioner for Refugees, were covered by insurance for vulnerable groups. 

This point is also important: the difference in premiums should not be conflated with the difference in hospital service tariffs. A premium is the amount paid to enjoy insurance coverage, while a treatment tariff relates to the cost of medical services. To conclude whether uninsured migrants are charged tariffs similar to health tourists, the specific tariff-setting regulations must still be examined.