The present paper aims to evaluate Algeria’s health insurance system in terms of its mandatory and supplementary components, given its pivotal role in achieving universal health coverage and upholding the principle of social solidarity. To pursue their key objectives, the scholars adopted an analytical approach to assess the existing state of these two health insurance systems and analyse their respective performances. The significant gains from mandatory insurance were highlighted, particularly in the expansion of demographic coverage. Besides, supplemental insurance played a supportive role in covering the remaining costs borne by the insured and in alleviating their pressing financial burden. The findings from the analysis revealed bottlenecks that hindered the sustainability of the system, ranging from ongoing financial pressure exerted by the funds due to escalating healthcare costs, the prevalence of chronic diseases, as well as the notable gap between approved reimbursement reference rates and the actual costs incurred by various treatments. These unprecedented challenges necessitate immediate action to develop novel alternative financing mechanisms for augmenting the funds’ resources, to update the reimbursement reference rates, and to accelerate digitisation to rationalise medical expenditures and strengthen oversight.