Health insurance in Ethiopia — individual and group plans compared.

01

Individual vs group plans

Individual health plans cover a single person or family. Group plans are purchased by employers and typically offer lower premiums per person. Most private sector employers in Addis Ababa now offer group health cover as a staff benefit.

02

What is typically covered

Standard Ethiopian health policies cover hospitalisation, surgery, diagnostic tests and outpatient consultations. Dental and optical are usually excluded. Pre-existing conditions may be excluded for the first 12 months or permanently, depending on the insurer.

03

Cashless vs reimbursement

Some insurers have panel hospitals where treatment is cashless — you show your insurance card and the insurer pays directly. Others operate on a reimbursement basis — you pay first and claim back. Cashless is more convenient but limits your choice of hospital.