The HIO covers around 60% of the Egyptian population, offering basic coverage to employees, students, and widows via its own hospitals and clinics. It was originally intended to provide blanket coverage for all citizens, but coverage has diminished over the decades since its inception.

The CCO contracts with individuals and companies to provide inpatient and outpatient care in specific Egyptian governates, such as Cairo and Port Said.

In 2019, the Egyptian government undertook a revision of national health insurance and is currently rolling out a new scheme, designed to offer truly comprehensive health cover under a more unified authority, the General Authority for Health Insurance. It also seeks to establish a directory of contribution payers and an electronic patient register, with a specific doctor and health clinic being responsible for each family (around 20,000 patients per clinic).

This is being organized by the WHO in co-operation with Egyptian health authorities, and its founding principles are based on need rather than ability to pay. It is organised on the principles of compulsory enrolment and subsidisation of the poor: everyone is enrolled in the system and no one will be able to opt out. The Egyptian government has committed to cover any citizen who is not able to pay for healthcare. At present, this new legislation does not cover foreigners.

The new scheme has begun in Port Said through 11 general and specialized hospitals and a further 32 healthcare units, and is destined to operate across the country by 2032. Its aims, as well as to provide cover for the poorest citizens, are to allow patients to choose their primary healthcare providers, and to reduce individual spending on medical care. Half a million people have been registered, and over 6,000 surgical procedures have been conducted under the new scheme.

The second stage of the new scheme will start from 2021 to 2023 in the Luxor, Matrouh, Red Sea, Qena and Aswan governorates. The third phase, from 2024 to 2026, will be in the Alexandria, Beheira, Damietta, Sohag and Kafr Al-Sheikh governorates.

The fourth, from 2026 to 2028, will be in the Beni Sweif, Assiut, Minya, New Valley and Fayoum governorates; the fifth phase (2029 to 2031) in the Daqahliya, Sharqiya, Gharbiya and Menoufiya governorates.

The final phase will be from 2031 to 2032 in the Cairo, Giza and Qalioubiya governorates.

Currently many expats either take out private cover, or choose to return home to receive treatment, or to travel to Dubai or the UAE, particularly for major surgery. This is expected to remain the case under the new system.

Everyone is technically eligible for healthcare if they have residency, and you will be entitled to use the current system if you are an expat. However, in practice, under 10% of Egyptian residents use the public scheme in its current form.

You should check with your employer to find out if you are covered under a group package. If you want to explore the possibility of making voluntary contributions (‘subscriptions’) into the system, then you will need to consult the Ministry of Social Solidarity (MOSS).

Currently, the state system covers:

• primary care
• hospitalisation
• emergency care

The new scheme is intended to cover a wider range of procedures including:

• open heart surgery
• bone marrow transplantation
• kidney and liver specialization
• neurology and micro-surgery

It will be a three-tier system, based on:

• primary health units
• hospitals
• hospitals specializing in heart diseases and tumors

Eight services are due to be provided through:

• primary health units
• GPs
• dentists
• pharmacists
• paediatrics
• obstetrics
• gynaecology
• emergency
• laboratory
• radiology

Most hospitals currently require cash in advance for treatment and you will need to retain any paperwork and put in a claim for reimbursement. You may be treated for free in an emergency, but will probably have to pay for any follow-up treatment once you are out of danger. The UK government website suggests seeking treatment at facilities attached to university medical schools, as these tend to offer a higher standard of care.

State insurance will pay:

• 10% of the cost of body scans
• 20% for laboratory tests with a maximum of LE 1,000 ($62)
• 7% for a hospital stay with a maximum of LE 1,500 ($93)
• 10% of the value of medication, rising to 15 percent after 10 years after the enactment of the law

Treatment for chronic diseases and cancer are not currently covered by national health insurance.

It is advised that you bring any prescription medication with you. You should have few problems purchasing medications over the counter, but may not be covered under the national scheme for your prescriptions.

If you are pregnant, it is advised that you take out private cover.

Egypt is not an unpopular choice among retirees, given its climate and the low cost of living. In addition, if you are from the USA, you will be exempt from US taxes on your Social Security benefits. It is, however, advisable to take out private health insurance in order to cover your stay in the country. If you opt to sign up to the national scheme, then you will need to make contributions of 2% of your monthly pension.

As an international student you will not be covered by national insurance and should take out private cover. You can consult your university or college for advice regarding private provision. The American University in Cairo, for instance, asks that students take out a comprehensive accident and sickness insurance plan, including emergency medical evacuation, non-medical emergency evacuation, and repatriation of remains.

Family members should be covered by your insurance, but you should double-check this with your employer or the Ministry of Health. You will need to pay an extra 1% of your income if you have a child, and if you have more than two children, you will have to pay an additional 1.5% in contributions per month. Your offspring cease to be defined as children when they either become employed or, in the case of girls, get married.

The new scheme will have provision for dental cover. Currently, however, there is very limited coverage under the national scheme and you will need to consider making out-of-pocket payments to a private dentist, enrolling in a dental treatment private plan, or seeking dental care abroad.

You will have to make a contribution of 5% of your monthly income, with a maximum of 7% if family members are included.

Egyptians working abroad and self-employed citizens must pay an additional 3% per month if their wives are not working.

Pensioners will pay 2% of their monthly pension, and fees for included family members will be subject to the same terms as above.

Employers must pay 4% of the monthly salary for each of their employees, with a minimum of LE 50 ($3). 5% of the minimum income rate will be contributed by the government to pay for the unprivileged. Contributions will see an annual rise of 7% and under the new law, citizens will be obliged to pay 7% of their income for operations and 20% for medical tests.

Private health insurance take-up among Egyptian citizens is low, around 10%, but beginning to increase. It is considered to be an underdeveloped market in the region, with most private policies held as part of employment packages. It is likely to increase, however, as the new national insurance scheme begins to come online, as the public sector involves the private insurance market more closely in its policies and strategies.

The new scheme will set quality standards for medical facilities to meet in order to be covered in the new insurance system; many hospitals are expected not to meet these standards and it is anticipated that some of these may sell their shares to private companies.

As a result of the low standard of public healthcare and extremely restricted national insurance coverage, most expats have traditionally paid out-of-pocket or relied on private health insurance. The new healthcare scheme is not yet fully in place and will not be fully implemented until the 2030s, and currently it is not intended to apply to expats.

You may need private insurance to cover more advanced dental care, prescription drugs, and surgical treatments in addition to speed of access for diagnosis and treatment and more advanced facilities.

This will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for (obviously, a more expensive insurance package will give you more a extensive range of treatment and facilities). As so many variables have an effect on the cost of international private medical insurance in Egypt it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

The big international providers cover Egypt, including:

• Allianz
• BUPA Egypt
• Cigna Global
• Foyer Global

Curative Care Organization (CCO) - a second organization governing national health insurance

Health Insurance Organisation (HIO) - the current Egyptian national scheme

Ministry of Social Solidarity (MOSS) - the Egyptian department of social security