The Maldivian government is set to introduce income-based contributions for the national health insurance scheme, Aasandha, targeting high-income earners as part of a broader effort to make healthcare more accessible for low-income and vulnerable populations. According to the newly proposed budget, individuals with monthly incomes exceeding MVR 60,000 will soon be required to make regular contributions, which will help support the costs of the public health insurance system.
This new contribution model is slated to begin in April 2025. The Maldives Inland Revenue Authority (MIRA) will be tasked with collecting the payments, mirroring systems in countries where health contributions are integrated into income tax collections. The funds generated from this initiative will be directed toward covering healthcare costs for citizens who may not be able to afford essential services, further strengthening Aasandha’s capacity to support those in need.
Under the plan, contributions from high-income earners will primarily cover outpatient services and non-essential medications, with contributors required to pay part of their treatment expenses. There will also be a cap on annual out-of-pocket costs to ensure that expenses remain manageable for those required to contribute. However, the government has yet to specify the exact rates or proportions of these health contributions.
In addition, from this month, individuals who have private health insurance will need to fulfill the required health contribution before they can access Aasandha benefits. These recent reforms aim to prevent the overuse of Aasandha by high-income citizens who already have private coverage, while ensuring resources are better allocated to those most in need.
The Aasandha scheme, which provides healthcare coverage for all Maldivian citizens, has faced rising expenses over the years, leading to calls for reforms to sustain the program’s viability. The government initiated these reforms two weeks ago, limiting Aasandha’s outpatient coverage for private insurance holders until their private coverage limits have been reached.
According to the Finance Ministry, the budget for 2025 includes a proposed MVR 56.6 billion, with total expenditure projected at MVR 49.2 billion. Aasandha-related costs make up approximately 5.1% of the expected recurrent expenditure, underscoring the scheme’s significant impact on the national budget. This move to introduce contributions from the wealthiest citizens marks a critical shift in how the Maldives seeks to finance public healthcare in the face of growing demands.
