The National Health Insurance Scheme in Nigeria (NHIS) is a program designed to provide access to affordable healthcare for all citizens. It was established in 2005 as a means to improve the country’s healthcare system and reduce the burden of out-of-pocket spending on healthcare for individuals and households.
Under the NHIS, eligible individuals and families can enroll in a health insurance plan and receive coverage for various medical services, including hospitalization, diagnostic testing, and preventive care. The NHIS is funded through government subsidies and premiums paid by enrollees.
However, one of the main goals of the NHIS is to increase access to healthcare in rural and underserved areas of the country. To achieve this, the NHIS has partnered with private and public healthcare providers to establish a network of facilities where enrollees can receive treatment.
Furthermore, despite its noble intentions, the NHIS has faced numerous challenges since its inception. These include issues with funding, corruption, and inadequate coverage for specific medical conditions. Despite these challenges, the NHIS remains an important component of Nigeria’s healthcare system and efforts are ongoing to improve its effectiveness and reach.
To ensure that every Nigerian has access to good healthcare services, the Nigeria Health Insurance Scheme has developed various programs to cover different segments of society, and these include:
The Formal Sector Social Health Insurance Programme is a social health security system in which the health care of employees in the Formal Sector is done from funds created by pooling the contributions of employees and employers.
The Formal Sector consists of the following:
Membership
Employees of the public sector and organized private sector organizations employing ten (10) or more persons shall participate in the Programme.
Registration
Anyone who falls under this category has nothing much to do because employers will have to register their employees. However, at the end of every month, 5% of your salary will be deducted as your contribution, for your and your family’s benefit.
This is another Program that is a social health plan/affordable health insurance product that allows mobile network subscribers to enjoy social health insurance coverage underwritten by accredited Health Management Organizations (HMOs) with services provided by NHIS-accredited healthcare providers across the country.
MEMBERSHIP
Nigerians or legal residents above 18 years that have a registered GSM telephone line from any of the Mobile Network Operators (MNOs). Nigerians/legal residents below the age of 18 years may be enrolled by their parents/guardians as adoptees.
BENEFITS
This unique IT-driven program takes advantage of the high teledensity in the country and allows Nigerians to subscribe to a health insurance package using their mobile phone. The IT platform allows a subscriber to enroll, select HMO & healthcare providers, and make a premium payment, etc, with unparalleled ease.
Another unique feature of this program is the flexibility of premium payment, allowing the premium to be paid either upfront annually, monthly, weekly, or daily, using airtime, Tailored Product Voucher (TPV) in addition to other electronic payment channels.
REGISTRATION PROCEDURE
The enrollment process is initiated by dialing *616# on the mobile phone on any mobile network. This action will activate the USSD menu which will take you through the entire process and allow you to input your biodata, select the Health Management Organization (HMO) & healthcare facility of your choice, as well as the periodic schedule of payment.
Successful completion of enrollment is confirmed by the issuance of an e-ID, sent through an SMS on the phone used for registration.
Although the unit of enrollment under the NMHIP is individual, an enrollee may register an unlimited number of individuals as adopted dependants.
Here is another health insurance that is taken up and paid for at the discretion of willing individuals or at the discretion of employers on behalf of the employee in an organization with less than ten staff.
Also, it is a program designed for those who are not currently covered by any of the NHIS programs and for those who may not have been satisfied with the existing healthcare services.
This program shall provide full or partial coverage for services that are excluded or not fully covered by the statutory health system. Premiums in Social Health Insurance are not risk-related and access to health care by voluntary contributors is always dependent on proof of contribution.
Family members of persons voluntarily insured in Nigeria’s social health insurance scheme are not covered as co-insured. The Enabling law establishing the Scheme and the Operational Guidelines of NHIS refers to these groups of people as:
A large number of financially viable Nigerian businessmen and women with staff strength of less than ten could not be categorized under the OPS program and are not yet covered.
An active self-employed individual not covered and categorized under CBSHIP but willing to participate in the program.
Retirees who wish to continue under NHIS Formal Sector Programme
Political office holders, Foreigners living in Nigeria (legal residents), etc.
Membership
Membership shall be voluntary and shall cover interested individuals, families, employers of establishments with less than ten staff, actively self-employed persons, political office holders at three tiers of government, and retirees not currently covered by any of the NHIS prepaid programs. Others are foreigners to Nigeria or persons with temporary residency status and Nigerians in Diaspora.
Please read the full article at The National Health Insurance Scheme in Nigeria (NHIS)
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