Banks and general insurance companies are now required to contribute to the Community-Based Health Insurance (CBHI) scheme, according to a new Prime Minister’s Order issued on February 23. ALSO READ: Mutuelle premium prices revised as scheme marks 25 years Marking 25 years, CBHI, commonly known as Mutuelle de Santé, is a solidarity-based health insurance system in which individuals/families pool contributions to access medical care. Established to help Rwandans, especially low-income earners, access healthcare at an affordable cost, the scheme now covers about 90 per cent of the target population. Under the new order, an entity providing banking services must contribute an amount equivalent to 2 per cent of its annual profit before tax to the CBHI scheme. The new introduction indicates that the contribution must be deposited into the CBHI bank account within 30 days after the end of the entity’s financial year. ALSO READ: Govt mulls Mutuelle de Santé review to improve access to medicines Contributions from general insurance companies An entity providing automobile insurance services is also now required to contribute 5 per cent of its annual profit before tax to the CBHI scheme. As with banks, the contribution must be deposited into the CBHI bank account within 30 days after the end of the entity’s financial year. ALSO READ: Drugs covered by Mutuelle double with Rwf20bn more funding Mutuelle scheme that is managed by Rwanda Social Security Board (RSSB) had been receiving funding from the already existing contributors including government support, members, traffic fines, telecommunication companies including MTN and Airtel, and health insurance, a component of the insurance sector. This comes after officials from the Ministry of Health and Rwanda Social Security Board told lawmakers in February 2024 that contributions from banks and general insurance firms could generate an estimated Rwf25-28 billion annually, helping to bridge potential funding gaps as the scheme covers costly treatments such as cancer care and kidney transplants. The reforms come alongside other changes, including a revised contribution structure. Under the new system, contributors are grouped into five income levels, replacing the previous flat contributions ranging from Rwf3,000 to Rwf7,000. Individuals with no income fall under level one and are required to contribute Rwf4,000 per year, an amount expected to be fully subsidised by the government. This group represents about 7 per cent of the population, according to RSSB. Level two includes people earning below Rwf30,000 per month. They must contribute Rwf4,000 and receive a government subsidy of Rwf1,000. This category accounts for 23 per cent of the population. Those earning between Rwf30,000 and Rwf60,000 per month are classified under level three. They are required to contribute Rwf5,000 without any subsidy and make up the largest share at 35 per cent. Level four covers individuals earning between Rwf60,000 and Rwf120,000 per month. They must contribute Rwf8,000 with no government support and represent about 27 per cent of the population. At the top, level five consists of individuals earning above Rwf120,000 per month. They are required to contribute Rwf20,000 without subsidy and account for 8 per cent of the population. According to the government, the reform aims to improve fairness by aligning contributions more closely with income while strengthening the financial sustainability of the scheme. The Ministry of Health has indicated that the following services are being added to the Mutuelle de Santé benefit package: haemodialysis, cancer diagnosis and treatment, kidney transplantation, advanced cardiac care through interventional cardiology, minimally invasive surgery, hip and knee replacement surgery. An expanded list of essential medicines covered by Mutuelle includes blood products, nutritional commodities, prosthetic and orthotic devices, as well as neurosurgical and orthopaedic procedures.
