Health insurance in Mauritania is divided into public and private systems, each with distinct features, target populations, and service quality levels. While both aim to improve healthcare access, they differ significantly in coverage scope, funding mechanisms, and healthcare delivery quality.
Differences:
One of the primary distinctions lies in target beneficiaries and accessibility. Public health insurance schemes, such as the Caisse Nationale de Solidarité Sanitaire (CNASS) and the Health Solidarity Fund, are primarily designed for vulnerable groups, including informal sector workers, rural populations, and low-income citizens. These programs often require voluntary enrollment and are subsidized by the government. Conversely, private health insurance primarily serves expatriates, the affluent urban population, and employees of large private firms. Access to private insurance is usually limited to individuals who can afford higher premiums or who receive it as an employment benefit.
Another major difference is in the quality and scope of services. Public health facilities, while expanding, are often under-resourced, especially in rural areas. Out-of-pocket expenses remain high despite insurance coverage, and the quality of emergency and specialized care is often inadequate. In contrast, private clinics in urban centers like Nouakchott and Nouadhibou offer superior service quality, including multilingual doctors and better-equipped facilities. However, even private care has limitations, and serious medical cases are frequently referred abroad to countries like Senegal or Morocco.
Funding mechanisms also differ. Public health insurance is primarily state-funded, supplemented by contributions from members and international donors. Programs like openIMIS-supported voluntary insurance aim to reduce out-of-pocket costs through donor support. Private insurance, on the other hand, operates on premium-based models, with individuals or employers paying for coverage. This includes options such as international health plans that provide evacuation and repatriation services, essential in a country where advanced local care is limited.
Similarities:
Despite these differences, both public and private health insurance systems share some common goals. They are part of Mauritania’s broader health sector development strategy, which aims to expand access, reduce financial risk, and improve service delivery. Both systems are also increasingly digitized, with CNASS offering digital registration and private providers embracing technology for claims and client management.
Additionally, both face challenges related to inequitable distribution of services and fragmentation of the healthcare system. Even though private care is higher in quality, its reach is narrow and mostly urban. Public insurance, while expanding, still struggles with institutional inefficiencies and uneven rural coverage. Both systems thus reflect the broader structural issues facing Mauritania’s health sector.
Top Public Health Insurances in Mauritania
Mauritania, a West African country with a largely desert landscape and a population dispersed across rural and urban zones, has a relatively modest healthcare infrastructure. The public health insurance system in Mauritania is still in the process of development and expansion. Currently, there is only one primary public health insurance scheme operating at the national level, which is the Caisse Nationale d’Assurance Maladie (CNAM). No other government-backed public health insurance schemes exist in the country, making CNAM the cornerstone of public health coverage in Mauritania.
1. Caisse Nationale d’Assurance Maladie (CNAM)(Official Website: https://www.cnam.mr/)
Cost:
CNAM operates on a contribution-based model. Contributions are typically deducted from employees’ salaries, with both the employer and employee sharing the payment. Public sector workers and formal private sector employees are automatically enrolled. Contribution rates vary, but for government workers, approximately 6% of the salary is deducted (shared between the employee and employer).
Available Services/Coverage Features:
CNAM offers a relatively basic but essential set of healthcare services. Covered services include:
- General practitioner and specialist consultations
- Diagnostic services (lab tests, imaging, etc.)
- Hospitalization (in public and some contracted private facilities)
- Prescription medications (with partial reimbursement)
- Maternity and child health services
- Some coverage for chronic diseases (e.g., diabetes, hypertension)
However, there are limitations in terms of the availability of advanced or specialized care, which often requires out-of-pocket spending or overseas treatment in countries like Tunisia or Morocco.
Open for All or Limited:
The CNAM system is not open to all citizens by default. It primarily covers:
- Civil servants
- Employees in the formal private sector
- Some retirees and dependents
Informal workers, unemployed individuals, and rural populations without formal employment generally fall outside the scope of this coverage, though efforts are underway to expand access.
Core Financial Features:
The insurance offers partial coverage. For instance:
- CNAM typically reimburses 50% to 80% of approved medical expenses, depending on the service.
- The rest must be paid out-of-pocket by the patient.
- In-network hospitals offer services at discounted or fully covered rates, while out-of-network providers require upfront payment followed by reimbursement.
Beneficiaries often need to navigate bureaucratic procedures for reimbursement, which can delay access to necessary services.
Consumer Satisfaction Score:
Consumer satisfaction with CNAM is moderate to low, estimated at around 50–60%. The main concerns reported by users include:
- Limited access to quality healthcare providers
- Bureaucratic delays in claims and reimbursements
- Lack of availability of medications and equipment in public hospitals
- Poor communication between CNAM and healthcare providers
Nonetheless, for those who are eligible, CNAM plays a critical role in reducing the financial burden of healthcare costs.
Top Private Health Insurances in Mauritania
Mauritania’s private health insurance market is relatively underdeveloped, reflecting the country’s modest economic status and small middle class. While public insurance like CNAM dominates coverage for formal employees, a few private insurers and regional providers offer health insurance policies tailored mainly for wealthier individuals, expatriates, international organizations, and employees of multinational companies. Currently, there are only a few private health insurance providers operating in Mauritania, either as local firms or through international partnerships. Below are the notable ones:
1. Société Générale Mauritanienne d’Assurances (SGMASSUR)(Official Website: https://societegenerale.mr/)
Cost:
Premiums vary based on coverage type, age, and health history. A basic individual plan may start from MRU 20,000–30,000/month (approx. USD 50–75), while premium family or corporate plans can be significantly higher.
Available Services/Coverage Features:
- Outpatient and inpatient care
- Specialist consultations
- Emergency services
- Prescription drug reimbursement
- Maternity services (limited)
- Some plans include medevac or regional hospital access (e.g., Morocco or Senegal)
Open for All or Limited:
Available primarily for corporate clients, NGOs, and high-income individuals. Limited access for the informal population due to cost.
Core Financial Features:
- Co-payment model: insurers typically cover 70–90% of costs
- Annual maximum coverage limits apply
- Some direct billing agreements with private clinics in Nouakchott
Consumer Satisfaction Score:
Estimated around 65–70%, with positive feedback for customer support but some complaints about claim processing times.
2. Assurances et Réassurances du Sahel (ARS Assurances)(Official Website: https://www.arstunisie.com/en/)
Cost:
Basic plans start from MRU 15,000/month (~USD 38), with premium coverage going up to MRU 100,000/month depending on the services included.
Available Services/Coverage Features:
- General and specialist consultations
- Hospitalization (local and regional partnerships)
- Diagnostic services
- Limited maternity and surgical procedures
- Travel and medical evacuation insurance available
Open for All or Limited:
Open to the public, though affordability restricts access mainly to professionals, businesses, and NGOs.
Core Financial Features:
- Partial reimbursement model (60–85%)
- Pre-authorization often required for expensive procedures
- Includes tiered plans for individual and family packages
Consumer Satisfaction Score:
Around 60%, with appreciation for coverage options but complaints about network limitations and paperwork-heavy processes.
3. Sanlam Pan Africa (Mauritania Division)(Official Website: https://www.sanlam.com/)
Cost:
As part of an international insurance group, premiums are higher—starting from MRU 50,000/month (~USD 125) for individual policies, and much more for expatriate-level plans.
Available Services/Coverage Features:
- Comprehensive local and international medical coverage
- Private hospital access in Mauritania and abroad
- Dental and optical services
- Chronic illness and surgery coverage
- Emergency medical evacuation
Open for All or Limited:
Primarily for corporations, expatriates, and international staff. Not tailored for general public access.
Core Financial Features:
- High annual maximum coverage (USD 50,000–500,000)
- Direct billing in select hospitals abroad
- Includes wellness and preventive services
Consumer Satisfaction Score:
Estimated at 75%, praised for quality and access, but criticized for cost and paperwork complexity.
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