The basic mandatory health insurance (AMO) guarantees coverage against health care risks and costs related to illness or accident, maternity, and physical and functional rehabilitation for insured persons and their dependent family members, regardless of the scheme they belong to.
The management of this scheme is entrusted to the CNOPS. It is managed separately from other schemes and has a dedicated Board of Directors.
Who are the target populations?
Beyond the age of 21 and up to the age of 30, medical coverage is provided to children if they are pursuing higher education in Morocco in one of the following categories:
- Higher education and Management/Executive training;
- Public education or preparatory classes of schools and higher institutes;
- Private vocational training;
- Traditional education (final cycle).
Applying for benefits shall be made in accordance with the T&Cs and/or procedures set forth by the regulations in force or determined by notes/instructions of the Managing Body.
The following are excluded from the basic "Students" AMO scheme
- CNSS or CNOPS policyholder/Affiliate or their beneficiaries;
- Members of the FAR[1] mutual insurance company or their right-holders;
- Beneficiaries of the medical assistance scheme – "RAMED" – or their right-holders;
- Insured of public or private authorities, who have internal funds or mutual insurance companies or collective agreements with insurance companies, or their beneficiaries.
In other words, any student who benefits, as a policyholder person or as a beneficiary of an insured person, from another medical coverage, whichever it may be, is excluded from the Students AMO scheme.
[1] Royal Army Forces
What does the basic mandatory health insurance cover?
As a student, you benefit from a partial reimbursement of your health expenses once you are affiliated to the CNOPS. This reimbursement corresponds to a rate of the conventional rate. You then have to pay the remaining amount of the health expenses.
What is the cost of this basic medical coverage?
Students must pay an annual fee of 400 MAD when they subscribe to the policy. The State fully covers the fees of students enrolled in public schools.
What benefits are covered by the amo?
As part of your basic mandatory health insurance, you have access to a range of health benefits and services, called the "basket of care", which will be reimbursed within the scope of your scheme.
Basic Mandatory Health Insurance |
Basket of Healthcare (Services) |
General medicine, medical and surgical specialties procedures |
Care related to the pregnancy and childbirth follow-up and monitoring |
Care related to hospitalization and surgical procedures including reconstructive surgery |
Bio-clinical analyses services |
Radiology and medical imaging |
Functional examinations |
Drugs eligible for reimbursement |
Close to human blood and blood derivatives |
Medical devices and implants necessary for various medical and surgical procedures |
Medical prosthesis and orthosis devices eligible for reimbursement |
Medical eyewear |
Oral care |
Orthodontics for children |
Functional rehabilitation and physiotherapy |
Paramedical procedures |
Preventive and curative care related to priority programs within the framework of the State Healthcare policy |
What about the amo reimbursement?
Reimbursement is made on the basis of the National Reference Rate set in the framework of national agreements signed between the concerned health professions and the Managing Bodies.
The Managing Bodies have a reimbursement period of:
- three (3) months for health care expenses incurred by an insured;
- six (6) months to reimburse health care institutions who have provided health care services to AMO affiliates within the framework of the third-party payment system;
- an SLA of 48 hours to respond to a claim.
In the event of a dispute with your mhi management fund
In the event of a dispute with your AMO management fund, we advise you to contact the fund first. If the dispute remains unresolved after this step, you can file a complaint with ACAPS via the platform dedicated to complaints management.
The Authority will then examine your complaint in its capacity as a Supervisory Authority and, if necessary, will take the appropriate action within the scope of its powers, in accordance with the applicable regulatory provisions.
To read further: reference texts
- Law 116-12 on the Mandatory Health Insurance scheme for students