Universal Public Health Insurance for Refugees in Iran; a Success Story

On the outskirts of Mashhad in northeastern Iran, a 48 year-old Afghan refugee lies on a hospital bed in a small health clinic. Connected to a dialysis machine, Habibollah’s blood circulates through his main artery, to and from the machine. He appears a little pale as the procedure takes place but he wears a broad smile as he greets the UNHCR Representative in Iran, Mr. Sivanka Dhanapala, who is visiting that morning.
Habibollah is benefiting from the second cycle of the government-run Universal Public Health Insurance scheme (UPHI) which is supported by UNHCR in the Islamic Republic of Iran. The comprehensive health insurance package enables all Afghan and Iraqi refugees in the Iran to access health insurance services similar to that of Iranian nationals, including hospitalization and para-clinical care such as radiology, doctor’s visits and the purchase of medicine.
Habibollah conveys how UPHI has relieved his financial pressures, since he could no longer work as a daily labourer once he was struck by his illness almost two years ago.
“I had to start going through weekly dialysis caused by untreated high blood pressure and diabetes”, he explains. At the onset however, Habibollah was not familiar with the disease and expected that only temporary treatment would be required.
When it dawned on him that he would need three dialysis sessions each week for the rest of his life, he struggled to come to terms with how these financial pressures would impact his family.
“The costs were outrageous” he exclaimed to the visiting delegation. “It was a big shock to my family, I became really disheartened and I found myself in a desperate situation before discovering UPHI”. The biggest challenge was how he could afford the specialist care now that he was unable to work.

“The high cost of treatment was an additional burden on my family of eight, who had now lost their sole breadwinner”

In this cycle of UPHI, one hundred per cent of the insurance scheme’s premium costs are covered by UNHCR for up to 142,000 vulnerable refugees - including those with special diseases[1] and their family members, like Habibollah and his wife and six children.
The advantages of UPHI goes beyond simply increasing access to healthcare for refugees in Iran, but creates large protection dividends and plays an essential role in enhancing refugees’ social security and resilience status.
As illustrated in Habibollah’s case, since enrolling in UPHI and receiving free dialysis he no longer has to worry about the means by which he would have to pay for treatment.
“There was a time we were knocking at every door asking for help from relatives and acquaintances to be able to cover a few more dialysis sessions, so I could live a few more days”, he remembers. “It was a time of despair and an experience I don’t wish to happen to anyone.”
Recognizing the value of health insurance through first-hand experience, Habibollah encourages all refugees to take advantage of the scheme. “I believe the value of insurance is only understood when the malevolent side of life comes to light” he emphasizes keenly, still linked to the dialysis machine.

“This insurance brought hope and relief to our family, and peace and joy back into our house”