Table 9 Benefits package in 2012 and amounts paid by MHO and patient
Services | Type of coverage by the MHO | % co-payment | Average amount of coverage by the MHO in MRO and (EUR) | Average amount co-payment in MRO and (EUR) |
|---|---|---|---|---|
Outpatient curative care | 100% above deductible | Deductible | 295 (0.79) | 200 (0.54) |
Antenatal care | 75% | 25% | 900 (2.4) | 300 (0.8) |
Flat fee for delivery in PSDN including referral | 75% | 25% | 2600 (6.97) | 900 (2.4) |
Deliveries in non PSDN facilities | ||||
Normal delivery in other health centres | 75% | 25% | 2607 (6.98) | 869 (2.33) |
Referral for complicated delivery + transport | Fixed reimbursement | Above ceiling | 5500 (14.74) | Unknown |
C-section in Cheikh Zayed (technical act only) | Fixed reimbursement | Above ceiling | 30,000 (80.4) | Unknown |
C-section in CHN (technical act only) | Fixed reimbursement | Above ceiling | 20,000 (53.6) | Unknown |
Laboratory in first line | 75% | 25% | 1136 (3.04) | 379 (1.02) |
Dental care | 50% | 50% | 1326 (3.55) | 1326 (3.55) |
Hospitalisation | Fixed reimbursement | Above ceiling | 30,000 (80.4) | Unknown |
Ambulatory hospital services | 100% up to ceiling of 5000 MRO | Above ceiling | 2776 (7.44) | 0 |
Medicines in private pharmacy | 50% reimbursed | 50% | ||
Medicines in private pharmacy for chronic care | 30% reimbursed | 70% | ||
Average amount medicines in pharmacy | 821 (2.2) | Unknown |