Compulsory Health Insurance (AMO) is instituted by Law 65.00 on the code of basic medical coverage. It provides basic mandatory medical coverage and guarantees universal access to health care.
The AMO thus offers equality and equity in access to care for all the population with the principle of collective and joint contribution to health expenditures.
Compulsory Health Insurance (AMO) is based on the contributory principle and the pooling of risks. It is characterized by the absence of any form of discrimination due to age, sex, nature of activity, level and nature of income. This is how the AMO allows:
- Systematic coverage of retirees
- Coverage of large risks without cap
- Coverage of potential risks and real risks (management of the age of the disease)
- The possibility of total or partial exemption of the remaining part borne by the insured
- The possibility of health care coverage abroad
- The possibility of support in third-party payment mode (TPM)
- Unlimited coverage of children with disabilities
- Maintaining coverage during:
- 6 months for the insured and his beneficiaries in case of cessation of activity
- 12 months for the spouse in the event of dissolution of the marriage bond
- 24 months for the beneficiaries in case of death of the insured.
Considered as AMO affiliated employers:
- Employers affiliated with the CNSS for social security benefits;
- State administrations, local authorities, public establishments and legal entities governed by public law whose officials and agents are, on the date of publication of the decree, on August 18, 2005, registered with the CNOPS;
- The organizations managing the pension schemes.
You are subject to the Compulsory health insurance obligation in the public sector managed by the CNOPS if you are:
- An official or agent in the public sector (the state, local authorities or public institutions);
- Seconded or made available;
- Beneficiary of a voluntary departure;
- Beneficiary of an exceptional pension;
- Retired public sector pensioner from CMR or RCAR;
- Beneficiary of pensions from an Internal Pension Fund;
- Beneficiary of the services of the Fund before the implementation of the compulsory health insurance (AMO);
- Pensioners receiving a pension from the CIMR
- Pensioners receiving a pension from the CNSS
You are subject to the basic health insurance obligation in the private sector managed by the CNSS if you are:
- Employee subject to the social security plan who does not have any other health coverage at the date of entry into force of the Compulsory Health Insurance,
- Voluntary insured,
- Fisherman sailor,
- Holder of a pension.
- The following are also covered, if they do not have personal coverage of the same nature:
- The spouse(s)
- Dependent children aged 21 and under
- Unmarried dependent children aged 26 and under and pursuing higher education
- Dependent children with disabilities, regardless of age.
The care covered by AMO includes the following acts:
- Preventive and curative care related to the priority program of the State;
- Care related to the monitoring of pregnancy, childbirth and its aftermath;
- Care related to medical and surgical hospitalization including the acts of the day hospital as fixed by the ministerial decree;
- Medical biology analyzes;
- Radiology and medical imaging;
- Functional explorations;
- Medicine admitted according to the list of reimbursable medicines;
- Blood and human blood bags;
- Medical devices and implants required for different medical procedures;
- Medical prosthesis or orthosis devices eligible for reimbursement;
- Medical eyewear according to the frequency defined by regulation (Law-65-00-AMO);
- Oral care;
- Facial Orthopedics for children.
What’s excluded from the scope of services guaranteed by the compulsory health insurance (AMO):
- Cosmetic surgery, spa treatments, acupuncture, mesotherapy, thalassotherapy, homeopathy and services provided in the context of so-called soft medicine;
- Care following accidents at work and occupational diseases.
- If you are active: the contribution rate is set at 5% of all salaries, divided equally with your employer;
- If you have any pension(s), the rate is set at 2.5% of all basic pensions;
- The minimum monthly contribution is 70 dhs and the maximum contribution is 400 dhs.
- If you are active: the contribution rate is set at 4.52% of all salaries, divided equally with your employer. This rate is increased by 1.85% to the exclusive responsibility of the employers;
- If you have any pension (s), the rate is set at 4.52% of all basic pensions;
- If you are a fisherman, the contribution is set at 1.36% of the sale of fish caught on trawlers and 1.70% on sardines and longliners;