1. What is the Universal Public Health Insurance (UPHI)?
The Universal Public Health Insurance (UPHI) is a national health insurance scheme that is available to refugees (Amayesh and Hoviat cardholders). This is a family insurance scheme and therefore the entire family must enroll. For individuals who are enrolled in the UPHI, the costs of hospitalization and para-clinical expenses (such as the cost of a doctor’s visit, medicine, testing and radiology) are covered at specific hospitals. These hospitals include those affiliated with the Ministry of Health (MoH) or others contracted with the Iran Health Insurance Organization (IHIO). A list of MoH-affiliated public hospitals is available and a list of hospitals contract by the IHIO is available here.
In 2021, UNHCR will cover the cost of the UPHI premium for 120,000 vulnerable refugees, while other refugees will be able to enroll in the insurance scheme by paying the premium fee themselves.
Note: When approaching hospitals for treatment, refugees should first check that the hospital accepts UPHI booklets prior to receiving any treatment. If you approach any other hospital besides the ones listed above, you may not be covered for the cost of treatment.
2. Why should I enroll in the UPHI?
No one plans to get sick or hurt, but most people need medical care at some point in their life. Having health insurance ensures that you are able to access health services if and when you need them.
If you are enrolled in the UPHI, when paying your medical bill at any public hospital affiliated with the Ministry of Health (MoH) or other hospitals contracted with the Iran Health Insurance Organization), your medical fees will be at a lower, discounted rate (similar to what Iranian nationals pay). This is because large portions of out-patient and hospitalization services such as doctor’s visits, medication, laboratory tests, x-rays and surgeries are covered under the UPHI.
By obtaining health insurance, you protect your family and yourself from expensive medical interventions in case of a health emergency or unexpected medical issues and reduce your expenditures for on-going medical treatments.
3. Who can enroll in the UPHI?
All Afghan and Iraqi refugees in Iran (individuals holding valid Amayesh, Protection Laissez Passer or Hoviat cards) can enroll in the UPHI. There is no age limit for individuals to be covered by the insurance scheme.
Please note that the UPHI is a family-based insurance scheme, meaning that all members of a family, including children, must enroll at the same time. Individuals who are considered as your family (and who therefore must be registered simultaneously) are those listed in the BAFIA database with the same family code as you. Individuals cannot enroll on their own.
4. How much does it cost to enroll in the UPHI?
The cost of the premium fee to enroll in the UPHI varies depending on the category under which you fall:
- Individuals under this category are refugees who, based on an assessment by BAFIA during the Amayesh registration, are determined to be particularly vulnerable. This group includes refugees suffering from a Special Disease (hemophilia, thalassemia, dialysis, kidney transplant and multiple sclerosis) and their family members.
- For vulnerable refugees, the premium fee for the UPHI is fully covered by UNHCR. You will only need to pay an annual fee totaling approximately IRR 80,000 to cover administrative costs, including the issuance of the UPHI booklet.
- The UPHI booklet, which is your proof of insurance coverage, is valid for twelve months (from 25 February 2021 to 24 February 2022) regardless of when the booklet is collected/extended. Therefore, we suggest that you obtain/extend your booklet as soon as possible to enjoy medical coverage.
- Refugees who are not on BAFIA’s list of vulnerable individuals will have to pay the premium fee to enroll in the UPHI. Currently, the monthly fee is IRR 1,315,000 per person.
- It is not possible to enroll in the UPHI for less than twelve months. Refugees will have to pay the premium fees for each individual in the family for the full twelve months upon registration.
- In addition to the premium fee, refugees will also need to pay a fee totaling approximately IRR 80,000 to cover administrative costs, including the issuance of the UPHI booklet.
- The UPHI booklet, which is your proof of insurance coverage, is valid for one year (12 months) from the date of enrolment.
5. How will I know if I am included in BAFIA’s list of vulnerable refugees?
To find out if you are included in BAFIA’s list of vulnerable refugees, and therefore qualify for free-of-charge health insurance covered by UNHCR, please approach your nearest Pishkhan center. If your name appears in their list, then you are considered as a vulnerable refugee. If you are not in the list, but believe you should be, then please approach your nearest BAFIA office.
6. What is considered a Special Disease under the UPHI?
Individuals who have Special Diseases can benefit from free-of-charge UPHI coverage. The following diseases are considered Special Diseases:
- Renal Failure
- Kidney Transplant
- Multiple Sclerosis
(Cancer is NOT considered a special disease under UPHI)
7. I have a Special Disease, but I am not included in the list of persons with a Special Disease in the IHIO database. How can I be covered under the UPHI?
If either you or a family member have been diagnosed with a Special Disease, but are not included on the list of persons with a Special Disease in the IHIO database, please approach your nearest BAFIA office and bring a certificate from a UPHI-recognized physician documenting your medical condition.
8. How do I enroll in the UPHI?
To enroll in the UPHI, please approach the nearest Pishkhan center. Only the head of the household needs to be present during enrolment – however s/he will need to bring the required documentation of all the family members.
The following documents are required for each family member:
- Afghan refugees: Valid Amayesh card or protection Laissez Passer
- Iraqi refugees: Valid Hoviat card
- 1 photo of each family member (size: 3cm x 4cm)
Vulnerable refugees: In addition to the above documents, individuals who fall under the vulnerable category will need to bring a bank card to pay the administrative fees at the Pishkan center or a bank receipt as proof of the payment already having been completed. Individuals who have Special Diseases should bring a certificate documenting their medical condition from a UPHI-recognized physician. To ensure that you are included in BAFIA’s list of vulnerable refugees (eligible to receive free-of charge booklet) please approach your nearest and ask for your vulnerability status. Vulnerable refugees do not have to pay the cost of the premium fee.
Premium payers: In addition to the above documents, individuals who do not fall in the ‘vulnerable’ category will need to bring a bank card to make the payment for the premium fee and the administrative costs at the Pishkan center, or a bank receipt as proof of payment already having been completed.
Once the documentation above has been provided and processed, each individual will receive a UPHI booklet – typically on the same day of registration.
9. Is it possible to pay my UPHI premium fee in monthly installments?
Unfortunately, no. Premium payers must pay the full cost of 12-month insurance coverage for each person in their family, in order for their health insurance coverage to start. Please note that the amount paid for insurance coverage would typically be far less than any amount you may need to pay in case of an unforeseen illness and/or medical incident without insurance coverage.
10. Can I be reimbursed for medical services I received prior to obtaining my booklet?
All vulnerable refugees who benefited from UNHCR’s assistance and received a free UPHI booklet are eligible for retroactive reimbursements for medical costs incurred from 25 February 2021. By submitting treatment bills dated after 25 February 2021 to your nearest IHIO provincial office, you can be reimbursed for your hospitalization costs. Please note that reimbursement is only possible for hospitalization costs while your outpatient bills cannot be reimbursed.
11. What medical services does the UPHI cover?
The UPHI provides coverage for outpatient, hospitalization and para-clinical services at any public hospital affiliated with the MoH or the IHIO. Para-clinical services include doctor’s visits, medication, laboratory tests, x-rays, etc. For details of paraclinical services covered by the UPHI, please contact the IHIO social worker at your local MoH-affiliated public hospitals. In case you need help, the staff at the front desk of the hospital can help you find the IHIO social worker.
Prior to initiating any health services, it is important that refugees get confirmation from hospital staff that the hospital is a Ministry of Health-affiliated hospital or clinic (under coverage of IHIO); this should always be done BEFORE receiving any services, as the UPHI does not cover services at other hospitals.
12. Will the UPHI cover medication that I buy from a private pharmacy?
Yes, under the UPHI the cost of medication that you buy from a private pharmacy will be covered, as long as it is medicine prescribed by a doctor at a public MoH-affiliated hospital or other hospital contracted with IHIO. The stamp on the prescription should indicate the name of the public MoH-affiliated hospital or other hospitals contracted with IHIO.
13. Do I have to pay a franchise fee when seeking treatment?
- Individuals covered under the UPHI will have to pay a 10% franchise fee for hospitalization services and a 30% franchise fee for para-clinical services. A franchise fee is a percentage of the medical bill that you have to pay yourself, while the insurance covers the rest.
- If you are a person with a Special Disease holding a UPHI booklet (either free of charge or premium payer) you do not need to pay a franchise fee for treatment pertaining to your Special Disease. You will however have to pay a 10% franchise fee for other medical services.
14. My newborn baby does not yet have an Amayesh card but needs medical treatment. How can he/she get medical insurance?
If the mother of the newborn child is already enrolled in the UPHI, then the baby is covered under the mother’s insurance for 28 days from the date of birth. In order to receive a UPHI booklet for the child, during this one-month period, the parents must:
- Approach their nearest provincial BAFIA office to register their newborn baby and obtain a referral letter.
- Approach their nearest Pishkhan center with the referral letter from BAFIA, along with the other required documents (refer to question 8).
- Pay the administrative fees totaling some IRR 80,000.
15. Shouldn’t I wait to enroll in the UPHI when and if my relatives or I need to go to hospital?
It is advisable to enroll in the UPHI as soon as possible, as you do not know if or when you or someone in your family may fall sick or require medical intervention. In case of a medical emergency, you and your family are likely to have to pay very expensive medical fees if you are not covered by an insurance.
There is also a waiting period of 10 days after the issuance of UPHI booklet before you can receive hospitalization services.
16. What if I enroll in the UPHI but I don’t use it, isn’t it a waste of money? Can I be reimbursed?
Getting health insurance is about managing the risk of having to pay large sums of money for medical care if a health emergency occurs in your household. Unfortunately, as is the case with all insurances, you cannot be reimbursed for the premium fee you paid for the UPHI, even if you have not needed health insurance in the coverage period.
17. What if I am asked to pay the UPHI premium fee in cash, or to an insurance company?
All booklet premium fees must either be paid electronically with your bank card or you must present a proof of payment of your fees at the Pishkan centre. Do not pay your insurance premium in cash under any circumstance. However, the administrative fees can be paid in cash at Pishkhan centres.
Please note: There are fraudulent persons and groups who may contact refugees, promising health insurance. They often issue insurance cards that do not have any photos or hologram stamps. These cards are not valid and will not provide you with health insurance – they are fake. To avoid these scams, make sure that you approach your local Pishkhan centres to enroll in the UPHI. If you see persons advertising health insurance that seems fraudulent, please report it to UNHCR.
You can report any fraud and/or complaints, as well as give us feedback, via one of the methods mentioned below:
- Contacting the hotline of UNHCR Offices:
- Tehran: (021) 88212520
- Esfahan: (031) 34442841 – 34414201
- Mashhad: (051) 37685641
- Kerman: (034) 32476850 – 32476851
- Shiraz: (071) 37229692
- Dropping a note in the complaint mailboxes in front of UNHCR offices
- Sending an email to [email protected] or [email protected]
In addition to the above, you can use the below email to report misconduct by UNHCR personnel, partner staff, or vendors/contractors including fraud, directly to the Inspector General’s Office at UNHCR Headquarters: [email protected].
18. One of my family members is not an Amayesh cardholder but has a passport. Can she/he also enroll in the UPHI?
Only refugees with a valid Amayesh card, Hoviat card or Laissez Passer can enroll in the UPHI.
If you are an Afghan or other foreign passport holder with an Iranian work visa, you can get health insurance via the Social Security Insurance Organization. For more information, please visit the SSIO website.
19. Should I renew my Amayesh/Hoviat Card?
Renewing the Amayesh/Hoviat cards for yourself and your family is important for many reasons, including making sure that you maintain your refugee status, which gives you certain rights and access to basic essential services in Iran. The UPHI scheme is only available to persons holding both Amayesh 15 or 16 and Hoviat card 14 and 15.