Beneficiaries of the Community-Based Health Insurance (CBHI) scheme, commonly known as Mutuelle de Santé, will be allowed to pay premiums in instalments and still access treatment before clearing the full amount, the Rwanda Social Security Board (RSSB) has said.

The revised premium structure will take effect in July 2026 as part of broader reforms aimed at improving affordability and sustainability of the scheme.

Households can check their contribution category through the Ministry of Local Government system by dialling *195#. Payments can be made via the RSSB system using *876# or through the Irembo online platform.

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"Citizens can pay any amount they have through Irembo or RSSB codes such as *909 and *876# for MTN Rwanda users,” said Dr Régis Hitimana, RSSB’s head of benefits.

"For example, if your annual premium is Rwf15,000, you can pay it in instalments. Once you have paid at least 75 per cent, you become eligible for treatment from July 1 to December 31,” he added.

The remaining 25 per cent must be cleared after December.

Hitimana said the instalment option was introduced after complaints from members who delayed seeking care while waiting to complete full payments.

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At the community level, beneficiaries are already adjusting. Immaculée Nyiranizeyimana, a community health worker in Kayonza District, said residents have formed saving associations to meet payment deadlines.

"We meet every month early in the year. Members save from Rwf500 upwards, depending on family size,” she said.

She noted that Mutuelle de Santé has played a major role in reducing maternal and child deaths, especially during malaria outbreaks.

"Mothers who deliver at health centres pay very little, and children with diarrhoea, pneumonia and other illnesses are treated promptly,” she said.

RSSB Chief Executive Officer Régis Rugemanshuro said Mutuelle coverage has expanded dramatically from about seven per cent in 2003 to more than 88 per cent in 2025 driven by payment-facilitation mechanisms.

"Coverage has never fallen below 85 per cent in recent years, and life expectancy has increased significantly,” he said.

However, expenditure by the Mutuelle fund has more than doubled, rising from Rwf39 billion in the 2015/16 financial year to Rwf98 billion in 2024/25, largely due to higher healthcare and living costs.

Community contributions have not kept pace. Annual premiums currently stand at Rwf3,000 or Rwf7,000 per person, depending on socio-economic status.

"Last year, the fund spent Rwf98 billion, but members contributed only Rwf31 billion—about 33 per cent,” Rugemanshuro said. "The Government covered the remaining 67 per cent, which made reforms unavoidable.”

Under the new system, members will contribute up to 48 per cent of required funding, while the Government will provide 52 per cent. Member contributions are projected to reach Rwf69.8 billion in the 2026/27 financial year.

Contributors are now grouped into five income-based categories.

Individuals with no income will pay Rwf4,000 per year, fully subsidised by the Government. This group represents about seven per cent of the population.

Those earning below Rwf30,000 per month will also pay Rwf4,000, with a Government subsidy of Rwf1,000, accounting for 23 per cent of citizens.

People earning between Rwf30,000 and Rwf60,000 per month will contribute Rwf5,000 without subsidy and make up 35 per cent of the population.

Those earning between Rwf60,000 and Rwf120,000 per month will pay Rwf8,000 and represent 27 per cent.

At the highest level, individuals earning above Rwf120,000 per month will contribute Rwf20,000 annually without subsidy, accounting for eight per cent of the population.

RSSB data shows that more than 90 per cent of members fall in categories requiring annual contributions of between Rwf4,000 and Rwf8,000.