CNSS improves AMO reimbursements

The CNSS administrators have taken a series of measures with regard to AMO. These include increasing the reimbursement rate for ambulatory care and hospitalisation to 80%, as well as the reimbursement of generic drugs.

New developments in AMO reimbursements. In today’s edition, The Economist reports that the CNSS administrators have decided to increase the reimbursement rate for ambulatory care and hospitalisation to 80%, as well as the reimbursement of generic drugs… The newspaper believes that the entry into force of these measures, which should improve the medical coverage offer for private employees, will wait until January 2020 and will therefore not require any increase in contributions.

In the meantime, the increase in the reimbursement rate will aim to reduce the proportion of the remaining costs borne by policyholders, which fell from 36% in 2012 to 38% in 2017, before falling by 1 point in 2018. “The increase in the level of reimbursements will encourage consumption by policyholders, a significant proportion of whom have low incomes,” the daily writes. Indeed, 39.2% of the workers with AMO rights are declared at a salary less than or equal to the smig, while only 10% earn more than 6,000 dirhams and CNSS pensioners with open rights receive less than 1,500 dirhams per month. The newspaper also notes that “69% of AMO beneficiaries earn an average monthly salary of between 1,000 and 3,500 dirhams. This population represents 69% of the benefits reimbursed”.

Among the other measures that L’Economiste mentions, there is the increase in the reimbursement rate for medical devices to 100% and the reimbursement rate for generic drugs to 90%. It should be noted that drugs are the main source of reimbursement (30%), followed by hospitalizations (24%) and dialysis (15%).

The revaluation of the national reference tariff for several acts, as well as that for optics, was also approved. The frame and lens will be reimbursed at 400 dirhams each and 800 dirhams respectively for progressive lenses. For dental care, the ceiling for prostheses will be 3,000 dirhams per year.

In addition, the increase in family allowances to MAD300 per child for the first three, granted as part of the social dialogue, will be applied retroactively from 1 July 2019, without increasing contributions for two years. There is also the revaluation of retirement pensions from January 2020.