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Services provided by the comprehensive health insurance system for patients

The Comprehensive Social Health Insurance Law promulgated by law stipulates that comprehensive social health insurance is a mandatory system, based on social solidarity, and whose umbrella covers all citizens who participate in the system, and the State supports their burdens by those who cannot do so based on a decision issued by the Prime Minister determining the exemption controls. It is the main unit of insurance coverage within the system, and this system is based on the separation of financing from the provision of services, and the Authority cannot provide treatment services or participate in providing them.

According to article (3) of the law, the services of the system include a set of health insurance services for all illnesses that are provided to the insured within the Republic, whether they are diagnostic, therapeutic or rehabilitation services. , or medical or laboratory tests. The above, taking into account the preservation of the financial and actuarial balance of the system.

The most prominent of these services:

  1. The family doctor or general practitioner in the specified treatment areas
  2. Specialized doctors, including those related to oral medicine and surgery
  3. Home health care when necessary
  4. Treatment and stay in a hospital or specialized center, performing surgeries and other types of treatment
  5. Examination of medical images, laboratory tests and other medical tests and the like.
  6. Rehabilitation, physiotherapy and prosthesis services in accordance with the basic lists issued by the specialized committees of the authority.
  7. Editing of medical prescriptions and dispensing of medicines and supplies necessary for treatment in accordance with the basic and complementary lists issued by the specialized committees of the authority, as well as the completion of the necessary medical reports.
  8. Primary and periodic medical examination for each job candidate to verify their health and psychological aptitude.
  9. Treatment abroad for those who cannot be cared for through the services provided within the Arab Republic of Egypt and have treatment abroad, based on a report issued by a specialized committee in this regard and made up of the authority , and the executive regulation clarifies its procedures and controls


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