The Truth Behind Health Insurance for Refugees in Iran


In a move that misleads readers and obscures multiple facts concerning the reality of refugees on Iranian soil, especially Afghan refugees who face discrimination in several sectors because of nationalistic reasons, mainly in the healthcare sector, the United Nations High Commissioner for Refugees (UNHCR) wrote on its official Twitter account that:

“Iran is one of only a handful of countries in the world that offer national health insurance to refugees, for essential secondary and tertiary public health services used by Iranian nationals.”

In this report, we shed light on refugee access to healthcare and examine the content of the UNHCR tweet.

According to the UNHCR, 120,000 refugees in Iran will have access to health insurance, according to an agreement reached between the UNHCR and the Iranian government to ensure that healthcare is provided to refugees.

It added that the health insurance includes treatment to tackle coronavirus infections and admission to hospital without charge. It also supports other medical costs such as surgeries, dialysis, x-rays, laboratory tests, and outpatient clinics. The UNCHR briefly pointed out that it will cover the costs and insurance payments for those refugees who are considered among the most vulnerable groups.

In this context, we can shed light on several points:

First, the UNHCR’s data confirms that Iran seeks to help the 120,000 refugees to access medical insurance. But what is the total number of refugees and immigrants? Tallies related to the number of refugees in Iran vary, depending on whether official government documents were obtained or not.

For instance, Iran’s official statistics suggest that the number of Afghan refugees is approximately 800,000. Meanwhile, Iran’s Deputy Foreign Minister Abbas Araghchi said last year that the number of refugees reached nearly 3 million on Iranian soil.

According to a study conducted by Cambridge University, more than 2 million Afghans live in Iran, and 40 percent of them are registered with refugee identity cards, 2 percent of them hold long-term residence permits, 22 percent hold short-term passports and 36 percent of them live in Iran without any official documents. However, it is clear that those refugees that will be helped by the UNHCR to access health insurance make up a small percentage of the total number of refugees and most of them are unable to apply for health insurance.

Second, the UNHCR will cover the 120,000 Afghan refugees’ health insurance costs, with the Iranian government not bearing any financial burden.

In a statement, the UNHCR reiterated that several refugees are unable to meet their basic needs, let alone cover their health insurance costs, which equate to approximately 40 percent of a refugee family’s average monthly expenses. This means that the refugees would not have accessed health insurance if it was not for the UNHCR and its commitment to cover health insurance payments.

Third, global information sources revealed that Iranian hospitals prevented the admission of Afghan refugees who contracted the coronavirus infection, which prompted thousands of immigrants and students to return to Afghanistan even though their homeland lacked adequate medical supplies.

        Refugees expressed regret that Imam Khomeini Hospital, one of the best hospitals in Iran, denied them access despite the remarks of Iranian officials that the healthcare system does not discriminate against refugees.

This means that different Iranian governments were unable to expand the scope of health insurance to cover large segments of Iran’s populace,  especially in the rural areas. The Iranian government did not move to place the refugees on health insurance program lists until their living and health conditions declined rapidly amid the coronavirus pandemic.

Fourth,  refugees and immigrants are not treated with respect. Iranian medical staffers and institutions treat them with contempt and discrimination. Moreover, the official bodies in Iran issued pieces of legislation preventing the placement of refugees and immigrants on the waiting list for organ transplantation surgeries. Iran’s committee on organ transplantation issued a decision, which prevents organs belonging to Iranian citizens being donated to foreigners under the pretext of “maintaining the dignity of Iranian citizens.”

Iran’s former Health Minister Hassam Hashemi is one of the staunch defenders of this decision. In a stark paradox, the same law does not prohibit the organs of immigrants and refugees being donated to Iranian patients. This sparked resentment among immigrants and refugees who constitute a considerable percentage of Iran’s population. They believed this decision to be racist and discriminatory against foreigners living on Iranian soil.

As a result, the UNHCR has overlooked multiple facts when it spoke of the Iranian government providing refugees access to health insurance on an equal footing with Iranian nationals, thus misleading readers into believing that both citizens and refugees are treated equally in Iran.

A refugee in Iran pays medical costs which are three or four times more than the costs paid by an Iranian citizen.

Yet, not all refugees and immigrants are allowed access to healthcare institutions as mentioned earlier, and they are also treated with disdain and contempt.

In addition, those who were helped in accessing health insurance constitute no more than 6 percent of the total number of documented refugees. They would not have accessed health insurance if the UNHCR did not agree to pay their health insurance installments, with the government-affiliated Iran Health Care Organization (Salamat) taking advantage of the financial benefits.

To sum up, we do not deny the benefits that the 120,000 refugees will gain due to the financial support provided by the UNHCR, resulting in them accessing health insurance in Iran. But the UNHCR tweet exaggerates the image of the Iranian government and its contribution in providing refugees with healthcare. Readers are misled due to a number of knowledge-related discrepancies.The UNHCR is the body that covers health insurance payments for several refugees in Iran. And this makes up a scant percentage of the total number of refugees and the rest are treated with contempt and discrimination, with Iranian medical staffers and institutions in Iran refusing to provide them with healthcare services, which prompted them to either return to their homeland or face chronic disease and dreadful living conditions.

Editorial Team