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

Table 2

Themes and subthemes extracted from interviews and national documents.

Theme	Subtheme
Insurance commitments and service coverage	(1) Low insurance limit for dental services; (2) Lack of clear principles for risk assessment and premium determination; (3) Lack of attention to preventive services; (4) Low service quality provided by contracted providers; (5) Inadequate contracted providers
Reimbursement system	(1) Inappropriate service authentication and reimbursement
Information system	(1) Lack of knowledge about contract details among insured people; (2) Lack of an integrated information system between insurance companies
Economic issues	(1) High costs of dental services; (2) Major financial contribution of dental services to complementary insurance; (3) Actual risk associated with dental service coverage
Population coverage	(1) Lack of dental coverage for small populations; (2) Lack of individual and family dental insurance
Regulation and supervision	(1) Dual position of the Central Insurance Organization (CIO); (2) Lack of specific complementary dental insurance; (3) Lack of identical and imperative tariffs; (4) Poor supervision of contracted providers; (5) Fraud in dental insurance

Codes derived from national insurance documents, rules, regulations, and instructions.