Exploring the Challenges in Covering Dental Services through Complementary Insurance in Iran: A Qualitative Study

Table 3

Solutions proposed by the interviewees to overcome the challenges of dental coverage by complementary insurance in Iran.

Solution category	Proposed solutions
Premium determination	(i) Establishing premiums based on an individual’s oral health status; (ii) Adjusting the annual premium based on an individual’s oral health performance in the previous year
Service coverage	(i) Including preventive dental services and compulsory annual checkups for all age groups; (ii) Ranking clinics based on the service quality
Information system	(i) Developing an integrated information system for insured people
Economic issues	(i) Revising tariff rates for dental services in accordance with the economic condition; (ii) Providing governmental support by revising the basic dental insurance package and reducing the financial burden of these services in complementary insurance
Population coverage	(i) Providing flexible complementary dental insurance based on individual characteristics, such as age and socioeconomic status to expand population coverage
Regulation	(i) Providing individual and family dental insurance in addition to group insurance; (ii) Developing clear rules and revising the existing regulations and instructions
Supervision	(i) Recruiting trusted dentists to review dental claims in all insurance companies; (ii) Determining a single tariff by the Ministry of Health along with strengthening the supervision of dentists; (iii) Using electronic records to prevent fraud