All About National Health Care Insurance In Nigeria And Reasons Why It Is Not Patronized

The united nation has cut down the life expectancy of males in Nigeria from 51 years, 6 months to 43 years, 6 months. This can be among other things lack of quality health care, low quantity of health care and cost of getting them. This is the main reason why a national health care insurance is necessary for every nation.

NHIS

It was in the year 1962 that there was an attempt to introduce health insurance to Nigeria. This did not stand the test of time due to the civil war that broke out in Nigeria in the year 1967 and did stop until three years later. It took close to thirty years for it to be re-visited in the year 1999. It took another couple of years before it was fully implemented. It started with about 150,000 applications that has risen to about 5 million in 2014. Initially, it was designed for federal staffs and their families only. That was a modest achievement, which represents about 3 % of the country’s population as at then.

Health insurance care is a cost effective way of paying for health services. Its payments option
protect the subscriber from paying the full cost of medical services when illness strike.

The National Health Insurance Scheme (N.H.I.S) is responsible for the management of funding health care services in Nigeria. It also tackles the provision of finances of citizens in unforeseen ill health situations. They regulate the activities of both private and public insurance companies in Nigeria. The scheme covers formal and informal groups. NHIS is like a group of individual that pools resources together to treat anyone who falls ill within the period.

They register Health Maintenance Organisation (H.M.O) and Health Care Providers (H.C.P). HMO are insurance companies while HCP are health care centers. So far so good, about 60 HMO and 60,000 HCP (mostly private) have been registered and accredited in Nigeria.

Reasons For Establishing National Health Insurance Scheme

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i. Poor state of the nation’s healthcare delivery system

ii. Excessive dependence and pressure on the federal government to finance the entire health care delivery system

iii. Rising costs and under funding of health care delivery system

iv. Poor integration of health care facilities in the health care system

Objectives Of National Health Insurance Scheme

Ensuring everyone has access to good health care and health care delivery services

Protect Nigerians from financial burdens of huge medical bills whenever they visit the hospital

Managing the rising cost of health care services

1. Ensuring equitable distribution of health care cost among different income groups

2. Ensuring adequate distribution of health facilities

3. Ensuring efficiency in health care services

4. Harnessing and improving private sector participation in the provision of health care services

5. Maintaining high standard of health care delivery services

6. Ensuring the adequate patronage of all levels of health care

7. Ensuring the availability of funds to the health sectors for improved services

In other to achieve these goals, several programs have been developed such as:

Formal Sector Social Health Insurance Scheme (F.S.S.H.I.P): This program is aimed at those who worked in an organised sector such as in government establishment, private companies with more than ten staffs, armed forces etc.

Informal Sector Social Health Insurance Scheme (I.S.S.H.I.P): They aim at Communities with their Community Based Social Health Insurance Program and those who come together voluntarily such as voluntary contributors social health insurance program.

Vulnerable Group Social Health Insurance Program (V.G.S.H.I.P): This plan is for those that are challenged physically. They include children, old people, orphans, prison inmates, etc.

Of all three, FSSHIP is the most common.

Let’s discuss how FSHIP works. However, before that it is wise to see terms that we may likely come across in this articles or when doing research on how to go about acquiring health care insurance in the nearest future.

Usage Of Terms

Insurance: Is defined as a practice by which a company (insurance company) provide a guarantee of compensation for specified loss, damage, illness, or death in return for payment premium.

Health Care Insurance: Can therefore be define as the guarantee of free or almost free treatment according to terms and conditions signed by both parties (applicant and Insurance Company) within a period of payment of a premium fee.

Policy Holder: The owner of an insurance usually the insured

Claim: A formal application or request for payment based on agreement

Insured: The person who obtain an insurance or the insured

Insurer: The Company who takes the health liability of the insured

Premium: Payment made by the insured to the insurer in exchanged for a guaranteed compensation

Coverage: The amount of risk or liability covered for an individual by the insurance company

Policy: A contract describing terms and conditions, covering premiums and deductibles

How Formal Sector Social Health Insurance Scheme (FHISP) Work

Premiums: An employer pays 5 % of the charges while the employee pays the balance, which is 10 %, making it total 15 %. This covers the health care need of the employee and those of his immediate family like spouse and four kids of less than twenty years old.

The Basic Benefits

1. Outpatient care including consumables
2. Prescribed drugs, pharmaceutical care and diagnostic test as contain in the national medicine index and diagnostic test list
3. Maternity care up to four live births
4. All new born eligible for the cover will be covered during the post natal periods up to twelve weeks from the date of delivery
5. Preventive care including immunization and family planning
6. Consultations with specialist such as physicians and pediatricians etc.
7. Hospital care in a standard ward for a stay limited to accumulated 21 days per year

Health Disasters That Are Not Covered

Occupational/industrial/natural disasters/social unrest/injury due to participating in extreme sports are not included in the plan

Transplant/cosmetic surgery

Drug abuse/addiction

Family planning commodities

Domiciliary treatment

Epidemics

Post mortem examination

Low Patronizing Health Insurance In Nigeria

There are about 4 million insured Nigerians in the health sectors with public insurance company while another 1 million in private company. This is very low compare to the population of the country. The reason for this can be attributed to:

1. Lack of awareness by the public on the health benefits such programs have on the populace. Others are

2. Poor financing and infrastructure by the government

3. Weak governance and insufficient risk pooling

4. Lack of infrastructure in the villages, doctors on strike professionalism, trust, patients right not been obeyed.

5. Non inclusion of traditional medicine

6. Naturally, in Nigeria, preparing for unforeseen unfortunate events is seen as an invitation to ill luck or ill health.

Now that you are aware of the benefits, get register today by following the process below.

Health Care Insurance Plane In Nigeria Registration

To register for a health care plan, decide on the company of your choice known as HMO. The insurance policy states the registered health care centers that they accept including the doctors. You cannot use your own doctor or health centers. Traditional Medicine are not accepted yet. These are known as primary health care providers. There are times primary health care providers may refer to a specialist; the company also covers such cost.

The premium is paid based on terms and conditions maybe daily, weekly or monthly. However, to cut down on deliberate hospital visit by those insured, they are expected to pay 10 % of the cost of drugs per visit.

To enhance health insurance in Nigeria, national mobile health insurance program was introduced. They collaborated with telecommunications companies like MTN, which is technically phasing out Voluntary Contributors Social Health Insurance Programs (V.C.S.H.I.P). Students in tertiary institutions also have their health care insurance program known as tertiary social health insurance programs.

Unfortunately, Nigerians have not come to value health care insurance. It is time we all come to appreciate health plans that are suitable for us. Get your own health care insurance today.

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