Health insurance in Ethiopia — CBHI, EHIS and private cover

Short answerChecked 28 October 2026

Health insurance in Ethiopia has two public schemes run by the Ethiopian Health Insurance Service (EHIS): community-based health insurance (CBHI) for households in the informal sector, which covered 63 million people in 13.67 million households across 1,195 districts in 2024/25, and social health insurance (SHI) for employees and pensioners, created by Proclamation 690/2010 and started for public health-sector staff in January 2026. Private medical cover is sold by the 18 insurers supervised by the NBE.

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On this page · 7 sections

The three kinds of health cover
The Ethiopian Health Insurance Service (EHIS)
Community-based health insurance (CBHI)
Social health insurance (SHI) for employees
Private health insurance
FAQ
Sources

The three kinds of health cover

	CBHI	Social health insurance (SHI)	Private medical insurance
For whom	Households in the informal sector (farmers, traders, the self-employed)	Employees and pensioners (formal sector)	Anyone; often group cover through an employer
Run by	EHIS, through woreda schemes	EHIS	Licensed insurers (NBE)
Who sets the price	Regional and city administrations	Regulation under Proclamation 690/2010	Each insurer
Compulsory?	No law we found makes it compulsory	Yes for employees and pensioners (Art. 5)	No
Where it stands	1,195 districts in 2024/25	Started for public health-sector staff in January 2026 (press)	Small: part of general insurance

The EHIS describes the split this way: CBHI is meant to cover about 80% of Ethiopians and SHI the remaining 20% (EHIS, August 2025).

The Ethiopian Health Insurance Service (EHIS)

The agency was set up as an autonomous federal body by Regulation No. 191/2010 (it was first called the Ethiopian Health Insurance Agency). According to the Ministry of Health, it has 24 branch offices across the country, collects and administers SHI contributions, and studies revisions of the benefit package and of contribution amounts.

Contact details published by the EHIS: Gotera, around the Pepsi factory, Woreda 7, Nifas Silk Lafto sub-city, Addis Ababa; phone (+251) 011 557 6721/23 or 011 557 6758/36; information desk 9060; ehis@ehis.gov.et; Monday to Friday, 8:30 am to 5:00 pm.

Community-based health insurance (CBHI)

CBHI is a prepayment scheme: households pay a yearly contribution into a pool at district (woreda) level, and members are treated at the contracted public health centres and hospitals. According to the Ethiopian Health Insurance Service:

In the Ethiopian budget year 2017 (2024/25), CBHI covered 1,195 districts, 13.67 million households and 63 million beneficiaries.
The Minister of Health reported health service coverage above 95%, and the EHIS more than 530 benefit packages.
The goal is health coverage for every citizen by 2030.

CBHI started in 13 districts in 2011; by 2025 it ran in 1,195, and contracted health care providers rose from 61 to 4,347 (EHIS).

How much does CBHI cost?

There is no single national price: regional and city administrations set the contribution and pay for the households that cannot. Addis Ababa, for example, replaced its flat fee of Birr 1,500 a year per household with an income-based scale in October 2025: most households pay Birr 2,000, middle-income families Birr 6,900 and the highest earners up to Birr 10,500; the city pays Birr 1,500 of the fee for the poorest, new members pay a Birr 200 registration fee, and older children or additional family members pay half the basic amount (Addis Fortune, 18 October 2025, press report). Ask your woreda health office for this year's amount and what it covers.

Social health insurance (SHI) for employees

The Social Health Insurance Proclamation No. 690/2010 makes employees and pensioners members of a national scheme (Art. 5), with their spouse and children under 18 as beneficiaries (Arts. 2 and 7). Employer and employee pay equal percentages of the salary (Art. 9(2)), and the employer deducts and transfers the contributions every month (Art. 9(3)).

After years of delay, the press reported that the EHIS started SHI on 22 January 2026 for government employees of the health sector, as a pilot (Addis Fortune, press report). Who pays what, who is covered and what comes next: social health insurance in Ethiopia.

Private health insurance

Private medical cover — individual, family or group through an employer — is sold by the licensed insurers as part of general insurance. It is the only option for treatment in private hospitals and, for many employers, a staff benefit on top of the public schemes. Before you sign, compare:

The annual limit per person and per family, and the inpatient and outpatient sub-limits.
The hospital network: where you are treated without paying first.
Waiting periods and how pre-existing and chronic conditions are treated.
Maternity, dental and optical: included or not.
Cover abroad, if you may need treatment outside Ethiopia.
How to claim, the documents needed, and how long reimbursement takes.

If a claim is refused, write to the insurer: it must answer within 10 business days before you can take it to the NBE. Our health insurance checklist lists the questions to ask, and our comparison with Kenya, Uganda, Tanzania and South Africa shows how other countries organise public cover.

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Frequently asked questions

How many people have health insurance in Ethiopia?

Community-based health insurance covered 63 million beneficiaries in 13.67 million households in 2024/25, according to the Ethiopian Health Insurance Service.

What is CBHI in Ethiopia?

Community-based health insurance: a prepayment scheme for households in the informal sector, run by the Ethiopian Health Insurance Service through woreda schemes. Members pay a yearly contribution set by their region or city and are treated at contracted public facilities.

What is the Ethiopian Health Insurance Service?

The federal body, set up by Regulation 191/2010 as the Ethiopian Health Insurance Agency, that runs community-based and social health insurance. It has 24 branch offices, according to the Ministry of Health.

Is health insurance compulsory in Ethiopia?

For employees and pensioners, yes in law: Proclamation 690/2010 makes them members of social health insurance. Implementation began with public health-sector staff in January 2026 (press report). We found no law making CBHI compulsory, and private cover is optional.

How much is CBHI per year?

It depends on the region or city, which sets the amount. In Addis Ababa, since October 2025, most households pay Birr 2,000 a year and the highest incomes up to Birr 10,500 (press report). Ask your woreda health office for the current amount.