Standard Health Benefit & Standard Premium Rate

Standard Health Benefit (SHB)

The Standard Health Benefit (SHB) are 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.

Standard Premium Rate (SPR)

The Standard Premium Rate (SPR) is the cost of providing SHB and financing the Mutual Reinsurance Fund (MRF). The SPR is a monthly deduction from every health insurance policy. The MRF is used to cover healthcare innovation and critical, high-cost services that pose a risk of dramatically increasing health insurance premiums and reducing healthcare access.

The reimbursement rates for SHB services and the money allocated for MRF are recommended annually by the Health Council and set by the Minister of Health.  When developing the reimbursement rates, the Health Council ensures healthcare market sustainability, inclusion of feedback from stakeholders, affordability of services, and, diversity of benefits that can support the health of individuals.

The current list of SHB services and their reimbursement rates can be found in the Reimbursement Rate Page.

MEMO- Standard Premium Rate for 2018-19