GENEVA - The U.N. refugee agency (UNHCR) reports it is covering the cost of health insurance for an additional 20,000 Afghan refugees in Iran. This boosts the number of refugees to 120,000 who will be able to access medical care for COVID-19 and other illnesses under Iran's national health plan.

Iran hosts nearly 800,000 Afghan refugees. Over the past year, the UNHCR has paid insurance premiums for 100,000 of the most vulnerable refugees. Given the dangers posed by the COVID-19 pandemic, it now has boosted that number by another 20,000.

UNHCR spokesman Babar Balloch says Iran is one of only a handful of countries in the world that allows refugees to sign up for its national health insurance and receive the same treatment as its nationals.

"The national insurance scheme allows for free COVID-19 treatment and hospitalization. It also subsidizes the cost of surgeries, dialysis, radiology, laboratory tests, out-patient care and more. However, many refugees are not able to afford the premium costs," he said.

Balloch said the pandemic has severely affected the ability of refugees to earn a living as they usually rely on precarious and unstable jobs. The cost of health care, he said, is unaffordable for most refugees as it represents about 40% of a refugee family's monthly expenses.

And, yet, in the time of COVID, accessing treatment could be a matter of life or death. The World Health Organization reports Iran is the most COVID-affected country in the Eastern Mediterranean region. The latest data show more than 1.9 million cases, including 63,000 deaths.

The UNHCR warns fewer refugees are likely to seek treatment for urgent health needs if they are unable to afford health insurance. The agency says it may not be able to continue subsidizing the cost of insurance premiums for the refugees due to its tight budget. The agency notes this year's UNHCR funding appeal of $97 million is only 7% funded.