National Health Insurance (NHI)
The National Health Insurance is the second major component of the Healthcare Fund and Palau's first social health insurance. NHI was designed to complement the Medical Savings Account, its concept is based on the solidarity of people coming together to help one another. This social health insurance scheme pools contributions from employers and voluntary individuals to fund the cost of catastrophic illnesses or prolonged injury. The National Health Insurance program is mainly funded by contributions from private employers, Palau National Government and voluntary individuals.
A National Health Insurance scheme referred to as Palau Health Insurance (PHI), which provides coverage against the risk of medical expenditure deemed as ‘catastrophic’, and which, according to PHCF rules and regulations, includes the following:
The cost for inpatient care provided at Belau National Hospital (BNH) and other public facilities including MOH dispensaries. A co-payment applies at 20 per cent (20%) of hospital charges up to a ceiling ranging from USD 100 to USD 400 depending on the insured persons’ household earnings.
The cost for off-island medical referrals authorized by the MOH Medical Referral Committee, including the cost of medical invoices and the cost of transportation (airfares) and/or medical evacuation if required, up to a maximum amount of USD 35,000 per case for medical expenses. Off-island referrals are subject to a co-payment of 20 per cent of total cost subject to a ceiling ranging from USD 1,000 to USD 4,000 depending on the insured persons’ household earnings.