Registration of beneficiaries

The beneficiaries of the AMO scheme are insured workers and their dependants.

Contributors comprise:

Members of Parliament,

Civil servants and military personnel,

Workers covered by the Labour Code,

Self-employed workers registered with the INPS,

Pensioners receiving pensions from the CMSS or the INPS.

All employees must be registered with CANAM (D.14). For the purposes of registration, persons holding an apprenticeship or training contract under the conditions laid down by the Labour Code are also treated as workers.

The dependants covered by AMO are:

• Spouses of insured persons,
• Dependent children
  • aged 0–14,
  • aged 14–21 for pupils and students,
  • With no age limit for disabled children with a permanent disability.
  • Direct ascendants who are dependent on the insured person.

Direct ascendants are defined as the insured person’s father and mother who are not personally covered by the Compulsory Health Insurance scheme.

If the ascendants are dependants of several insured persons, they remain attached to the first insured person who registered them. However, if that first insured person ceases to be eligible to cover the ascendants, they may be transferred to the account of another eligible descendant.

Where children are registered by both parents who are covered by the scheme, the parents shall mutually agree on which parent each child will be linked to.

An employee’s registration is subject to an application by their employer or by the employee themselves using a form provided by CANAM. Upon registration, the insured person must subsequently declare their dependants, providing the required civil status documents:

• Birth certificates of the insured person, their spouse, children and ascendants,
• The insured person’s marriage certificate,
• Certificate of life for children under 14,
• School attendance certificates for children aged 14–21,
• Medical certificate for children with disabilities,
• Certificate of dependency for parents.

The registration of beneficiaries (insured persons and dependants) by CANAM must take place within 30 days of the application. This involves registering the beneficiary and issuing them with a social insurance number, together with a health insurance card for each beneficiary.

The insurance card is valid throughout Mali and must be presented to any registered healthcare provider to claim the care to which the holder is entitled under the AMO scheme.

In the event of any doubt regarding the insured person’s identity, the healthcare provider is entitled to request a form of identification that matches the insurance card.

If the card is lost, CANAM will, at the insured person’s request, issue a new insurance card upon payment of a fixed fee set by the Board of Directors.

The insured person’s card is invalidated by CANAM when the beneficiary ceases to be entitled to AMO benefits. In this case, they are required to return the card to CANAM.