Aasandha Scheme Amended: Overseas Treatment Now Accessible for Locally Available Procedures Based on Patient Condition

News

In a major overhaul of the national social health insurance policy, the government has officially amended the Aasandha Scheme Regulation, allowing Maldivian patients to seek medical treatment abroad for procedures that are already locally available.

Under the newly enacted amendment, medical referrals overseas will no longer be strictly limited to treatments completely unavailable within the Maldives. Instead, the Aasandha Company will now evaluate applications based on a broader, patient-centric criteria. This includes assessing the specific type of illness, the patient's current medical condition, any practical difficulties or delays faced in obtaining the treatment locally, and various surrounding socio-economic factors.

To qualify for this extended coverage, patients must be referred to overseas medical facilities that are explicitly empanelled within the Aasandha network. Furthermore, the updated regulation stipulates that financial assistance can be extended even if the required treatment is not traditionally registered under the standard list of covered services, provided the patient’s condition warrants it.

This policy shift marks a departure from the scheme's historical framework. Previously, Aasandha operated on a strict exclusionary model, approving overseas funding exclusively when local state and private hospitals officially certified that a specific life-saving or specialized treatment could not be performed anywhere within the country.

Streamlined Domestic Referrals

In addition to the cross-border changes, the amendment introduces significant administrative relief for domestic inter-island and regional medical transfers.

Previously, a patient could only be officially referred to a higher tier or urban medical facility if the recommendation was signed off by a certified specialist in that exact field of medicine. Recognizing the severe shortage of specialized medical personnel in the outer atolls, the new rule provides critical flexibility: if a island or atoll lacks a relevant specialist, Aasandha is now authorized to accept and clear referral paperwork issued by any general practitioner or medical officer officially approved by the company.