How does SKY work?

The major features of SKY health insurance are as follows.

The health insurance program:

• Targets vulnerable rural households
• Follows a community based and voluntary membership approach
• Covers all members of the family (family membership required)
• Has a clear social mission / must be affordable for all rural households including large and poor families
• Follows a pragmatic membership approach, taking into account rural households and enabling them to join the program easily (monthly payment, registration open throughout the year)
• Encourages stable / long term memberships (waiting periods, dropout penalties, etc.) in order to minimize Drop-Outs and maximize outreach
• Is designed in consultation with the direct beneficiaries in the villages
• Covers both primary health care and hospital care with a mandatory referral mechanism
• Works in partnership with public health facilities through capitation payment mechanisms and close monitoring (to enhance quality assurance and cost containment)
• Is fully transparent: health insurance financial statements are displayed in each village’s Health Insurance Consultative Committee (including elected insured representatives)
• Works in partnership with Health authorities (MoH central and provincial level) to fit within national health policy and guidelines
• Is private and independent of health authorities or health providers / aims to be managed by Cambodian managers with local insurance agents based in the village
• Is non-profit (subsidized by external donors) with the long-term goal of becoming financial sustainable