Access to Private Health Insurance for the Elderly in Cameroon

By Musa Nji, Dr. Asahngwa and Dr. Ronald Gobina

Executive Summary

Cameroon’s elderly population is growing steadily, increasing the demand for healthcare services, particularly for chronic non-communicable diseases such as hypertension, diabetes, stroke, cancer, and kidney disease. Despite their high healthcare needs, most older adults lack adequate financial protection and rely heavily on out-of-pocket payments. Existing social protection mechanisms, including pension schemes, cover only a small proportion of the elderly population and provide limited support for healthcare expenses. While private health insurance (PHI) has expanded in Cameroon, current products remain largely inaccessible to older adults due to affordability constraints, age-related exclusions, and limited coverage of chronic conditions. Strengthening PHI for the elderly presents an opportunity to improve access to healthcare, reduce financial hardship, and complement ongoing Universal Health Coverage reforms. Achieving this will require targeted government support, stronger regulation, innovative insurance models, and multi-stakeholder collaboration to ensure that PHI schemes are inclusive, affordable, and responsive to the health needs of Cameroon’s ageing population.

Key Messages

• Cameroon’s growing elderly population faces a rising burden of chronic diseases, requiring sustained and affordable healthcare services.
• Most older adults lack adequate health insurance and depend on out-of-pocket payments, increasing their risk of financial hardship.
• Existing pension and social protection systems provide limited healthcare coverage for the majority of elderly people.
• Private health insurance could improve healthcare access for older adults if products are designed to address their specific health needs.
• Government support, stronger regulation, and multi-stakeholder collaboration are needed to make PHI more inclusive and affordable for the elderly.

Background

The elderly population consists of individuals aged 65 years and above and is generally associated with the age threshold to start receiving pension benefits. In Cameroon, the elderly population was estimated to be 0.84 million in 2025 with demographic forecasts showing that this population segment keeps growing steadily, just like in other nations in the sub-Saharan African region. Elderly persons constitute a special interest group for several reasons notably, the life record of service to the nation in diverse sectors including family life, community development, culture, agriculture, technologic development and innovation as well politics. Once in advanced ages, the elderly develop age-related frailty and get exposed to peculiar health issues that jeopardize their wellbeing and dignity. Some of the health issues developed relate directly to the nature of their occupation, fueling the need for considerations in the post-work period by diverse employers including the state.

The problem of non-communicable diseases (NCDs) among the Cameroon elderly population is increasing due to lifestyle and epidemiological transitions, leading to an increase in chronic diseases conditions such as hypertension, diabetes, stroke, arthritis, cancer, kidney diseases and depression. The long-term, continuous, and usually expensive nature of the care of older persons with NCDs includes frequent medical visits, laboratory tests, and lifelong medications. Financing of healthcare in Cameroon is currently characterized by the predominance of out-of-pocket payments, and social protection of the aged population is insufficient or absent. Studies reveal about 90.7% of elderly have numerous chronic conditions with more than 65% taking a minimum of three different medications on periodic or ongoing basis. The elderly population in Cameroon is underinsured because the country’s social insurance system only covers formal sector employees, who are subject to taxes and social contributions. As a result, the elderly face challenges in meeting up with medications and ongoing treatments Although private health insurance is growing in Cameroon, the current schemes are ill-suited to the risk profile of older adults with NCDs. This results in delayed care and interruptions as well as increased economic hardship for many older individuals with NCDs, highlighting the necessity to develop inclusive financing solutions like private health insurance (PHI).

Health challenges faced by the elderly in Cameroon

The burden of disease is disproportionately high among older persons in Cameroon especially those with chronic and degenerative ailments. The most frequent ones being hypertension with a prevalence reaching 55.9% in urban areas and 43.8% in rural areas as well as  diabetes whose prevalence is surging towards 20.1% in the urban areas and 12.7% in rural areas. Other NCDs also prevalent among elderly people include cancer, stroke depression, and kidney diseases.  Evidence from the Buea Health District, as well as other urban areas, has shown that cases of multimorbidity are high among the elderly groups, with most of them experiencing two or more chronic conditions at the same time. These disorders greatly hinder functional ability, diminish autonomy, and increase healthcare demand, get diagnostic tests, and require long-term drug administration. The net impact of these medical issues makes it clear why private healthcare financing mechanism is required to promote sustained, all-encompassing, and affordable care among the elder population.

Barriers hindering the elderly from health care access

The main limitation to accessibility of healthcare among the elderly in Cameroon is financial numerous elderly people depend entirely on pensions to survive while others are dependent on support from family. Even then, there are challenges with respect to pension schemes which sometimes are activated after significant delays and often the pension premiums are inadequate to meet high standards of living. Others have no pension at all, especially those in the informal sector where they do not have a stable source of income to meet up with contributions required to deserve pension premiums. In addition to all this, several aged people are still subject to the economic burden of taking care of children, grandchildren and other dependents for diverse reasons.  Urbanization, migration, and economic crisis have limited the support systems of the traditional family, leaving the elderly parents without economically active relatives or relatives who might offer daily care and monetary assistance. It is also noted that 8.8% of elderly people are family caregivers. Consequently, the high out-of-pocket payments to consultations and diagnostics and long-term medication often results in the delay of care seeking, interruption of treatment, or total forgoing care among older adults. The lack of insurance for the elderly makes it difficult for them to acquire or afford medical services. 

Government Interventions to enable the elderly to get healthcare.

The government of Cameroon has made selective interventions through the ministry of social affairs (MINAS) who is a signatory of the madrid+10 plan to assist the elderly in accessing healthcare services through campaigns targeting people living with disabilities and who are highly exposed to the diseases, mostly through policy frameworks, subsidies, and partnerships. The government of Cameroon equally provides social security for the elderly through the pension system which covers only a very small proportion of the elderly population (5.4%). Paradoxically, pensions paid to retirees remain paltry compared to the relatively high cost of living. They do not benefit from any health insurance that could compensate for the lack or inadequacy of their retirement pensions. Universal Health Coverage (UHC) phase 1 initiative introduced by the Cameroonian government in 2023 targets vulnerable populations but does not specifically target the elderly population, which results in gaps in special programs. UHC Phase I is aimed at pregnant women, children below 5 years, and chronic diseases such as HIV, tuberculosis, river blindness and dialysis but although alignment exists, these policies emphasize on maternal-child health and are selective on chronic diseases, not focusing on long-term management of NCDs specific to the elderly.  Consequently, current social support initiatives are inadequate to cover the long-term healthcare requirements of the ageing population, resulting in reliance on out-of-pocket payments and family assistance.

The role of private health insurance in improving access and utilization of health services for the elderly in Cameroon

Private health insurance operations in Cameroon have limitations because they are focused more on wealthier families,  public or formal private sector employees, leading to the exclusion of the vulnerable populations and informal sector employees who constitute the majority (90%) of the active population in the country.  PHI has the potential to enhance healthcare access for the elderly in many ways by designing products to meet their needs due. Primarily, an enrolment can be done in the form of family enrolment, community pooling, or cross-subsidization so the elderly people who lack CNPS pensions, especially those in the informal sector, may benefit from coverage. More so, PHIs can tailor benefit packages to the epidemiological profile of the elderly, which covers common chronic diseases such as hypertension, diabetes, stroke, arthritis, depression, and kidney disease to older individuals which are not covered by any formal social protection at all. In addition, PHI has the potential to sustain universal health coverage (UHC), including services beyond the UHC phase 1 benefit package, to decrease out-of-pocket expenditures and the strain on public facilities. These functions demand a high degree of regulation and collaboration among the government and the private sector to provide affordability, avoid age-related exclusion, and streamline PHI activities with national equity objectives.

Policy recommendations

1. Establish a multi-stakeholder platform to promote elderly-inclusive PHI policies: The Government of Cameroon, insurance regulators, private insurers, pension institutions, healthcare providers, and civil society organizations should collaborate to develop and implement policies that require PHI schemes to address the healthcare needs of older adults. This should include minimum benefit standards for age-related chronic diseases, long-term care services, and protections against age-based exclusion.
2. Subsidize elderly-inclusive PHI schemes: The Government of Cameroon should provide targeted premium subsidies or co-financing for older adults, particularly retirees with low pensions and elderly persons in the informal sector. Incentives should also be offered to insurers that develop affordable products tailored to older adults.
3. Strengthen regulation against age-based exclusion: Insurance regulators should prohibit discriminatory practices based on age or pre-existing conditions and ensure transparency in premiums, benefits, waiting periods, and claims procedures.
4. Promote community and family-based insurance models: Government and insurers should expand community risk-pooling, family enrolment, and cross-subsidization mechanisms to improve PHI access for older adults, particularly those outside the formal sector.