For example, in Iran, health insurance for Afghan refugees was introduced in 2011. By June 2012, 347 000 refugees had enrolled in the scheme, representing 40% of registered refugees (UNHCR unpublished data). These refugees now have the opportunity to access secondary and tertiary health care for treatment of NCDs, and they have a second form of official documentation. By introducing this insurance scheme, the Iranian government has reduced the risk of having to pay for the hospitalization of refugees, and UNHCR and its partners now have more detailed data to improve their programs in other sectors beyond health. The refugee health insurance scheme works in Iran because the program is state approved, and a similar system is in place for host populations; refugees have access to employment that allows many of them to afford to pay the premiums and co-payments, and UNHCR pays for vulnerable persons that cannot do so. Examples of other health insurance schemes for smaller groups of refugees exist in Cambodia, Costa Rica, Georgia, and in some countries in West Africa, with varying levels of success. Given the positive experience in Iran, UNHCR has begun to explore the possibility of implementing such health insurance schemes in other countries, particularly in middle-income countries where refugees are generally settled in urban settings.