Under the services offered within Standard Health Benefit (SHB), as well as hospital treatment by private physicians and dentists, reimbursement rates are regulated. The SHB is the services mandated to be included in every health insurance policy. This includes some inpatient and outpatient care, Home Medical Services and diagnostic imaging services. Supplemental coverage, such as dental care, is not included but is still available for purchase through local insurers.
The Standard Premium Rate (SPR) is the cost of providing SHB and financing the Mutual Reinsurance Fund (MRF).
The reimbursement rates for the SHB and the SPR are set by the Minister of Health and are reviewed annually to ensure healthcare market sustainability, inclusion of feedback from stakeholders, affordability of services, and diversity of benefits that can support the health of individuals.
The approved providers and reimbursement rates for diagnostic imaging services and Home Medical Services for 1st June 2017 -31st March 2018 are listed below. Approved providers are prohibited from charging beyond the regulated reimbursement rate levels for these procedures. All fees for services provided by private practitioners are set by the health professionals delivering care.