Health Financing and Insurance Department handles the health insurance scheme design, and sets the policies, procedures and standards necessary for the application and supervision of health insurance. It also monitors the participating entities and the health and insurance services they provide to beneficiaries and takes the necessary measures to ensure the scheme’s sustainability, efficiency and development in accordance with the provisions of Law No. (22) of 2021.
 

Mandatory health insurance scheme:

It is a scheme that aims to provide insurance coverage for basic healthcare services for expatriates and visitors  of the State of Qatar. The scheme is implemented in stages, and the first phase begins with covering visitors for emergency and accident services. 

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Functions and responsibilities of the Department:

The duties and responsibilities of the Department are based on protecting the interests of the Stakeholders  involved in the health insurance scheme with the aim of giving priority to beneficiaries, protecting their rights, and ensuring that they receive safe and high-quality care. Pursuant to Law No. (22) of 2021 and Article (7) of Emiri Decree No. (36) of 2022 on the Organizational Structure of the Ministry of Public Health, the Health Financing and Insurance Department is specialized in the following:

1. Provide an integrated health insurance scheme that is high quality, efficient and sustainable.

2. Develop necessary policies, procedures, standards and systems for implementing  of the health insurance scheme in accordance with the provisions of the law regulating the provision of healthcare services within the State and supervise its implementation.​

3. Determine the basic healthcare services packages according to the categories of beneficiaries, the level of healthcare services to be provided for each category and determine the conditions and controls of the healthcare providers network that health insurance companies can contract with.

4. Price and determine the mechanisms for financing healthcare services within the health insurance scheme, calculating, applying, and reviewing health insurance premiums, and determining the collection and healthcare provider payment methods.

5. Register the healthcare providers and insurance companies in accordance with the standards and conditions set and approved in the law and the regulating decisions.

6. Prepare and implement coding systems of various health services patient classification systems, and set the minimum necessary data, and determine the mechanisms for filing and paying financial claims and their arbitration mechanisms.

7. Prepare and implement stakeholder awareness and dispute mechanisms related to the health insurance scheme.

8. Monitor the stakeholders’ performance to ensure their compliance with the laws and decisions.

9. Set the rules for insurance support and propose the covered categories.

10. Issue instructions and bulletins explaining policies and procedures related to the implementation of the health insurance legislation.​

Article (2) of Law No. (22) of 2021 defines the competencies of the Ministry of Public Health regarding the mandatory health insurance scheme.

Vision, Message, Values and Strategic Objectives:

​The establishment of the health insurance scheme represents a major achievement in delivering the health objectives of Qatar National Vision 2030 and the National Health Strategy 2018-2022, which aims to create a comprehensive healthcare system on a global level, whose services are accessible to all residents. The health insurance scheme supports the five priority areas and the seven priority population groups of the National Health Strategy 2018-2022, as illustrated in the figure below. 

Mission

“As the Regulatory Authority of the mandatory health insurance scheme, we strive to ensure that all stakeholders are treated fairly and ensure the protection of their rights, as stipulated by the law and without prejudice to any party”.

Vision

Beneficiaries have access to affordable, high-quality healthcare services when needed”.

Values

Focus:  Our regulations target the "issue" being addressed, to minimize the impact on other activities.

Consistency: In line with the objectives and approach of other regulatory entities (particular importance in areas where authorities and functions overlap)

Accountability: Explain the reasons for our decisions and justify them with evidence.

Proportionality:  Proportionately use regulatory systems and policy to achieve the necessary and desired results. 

Transparency: Clarity in terms of functions, requirements and enforcements.

Sustainability: Define the regulatory framework and give adequate notice to regulators about modifications that can be done.  

Strategic Objectives

1. Improving healthcare access for different population segments. 
2. Protecting the rights of all stakeholders participating in the scheme, by regulating the health insurance market tightly in coordination with the regulatory authorities in the country.
3. Improving the financial sustainability of the healthcare system by introducing the insurance as an additional means of financing health services
4. Creating opportunities to increase the participation of private healthcare providers
5. Promoting and developing the health insurance industry in the country through the participation of private insurance companies
6. Develop the strategic healthcare planning by improving data management, data analysis and reporting systems.​