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Nhis(national Health Insurance Scheme) - Health - Nairaland

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Nhis(national Health Insurance Scheme) by upmanagers: 10:39am On Jul 01, 2014
I started this topic to educate and enlighten those that wanted to no more about NHIS but all my topics where cleared so am starting all over again. As I said in my previous post, I may not be able to check this post everyday but I would try to do that twice a week so if their is any question(s) please don't fail to ask and I will do my best to give answers to them.

NHIS is a health insurance plan programme for every individual in Nigeria. Our offices in lagos
> Lagos Zonal office: 443, Herbert Marculay way, yaba.
> Ikeja state office: 112, awolowo way, balogun bus stop, ikeja.

Various programs are:
1. Formal sector social Health insurance programme i.e it is a health insurance programme for employees in the public sector and organised private sectors(ops). Ops is a private company that has 10 staff and above. Formal sector covers staff, spouse and four biological children.
2. Volunty contributors social health insurance programme (vcship) is for individuals who do not work in formal sector or who do not belong to a community ot tertiary institute that is covered under nhis. Its cost is 15,000 yearly in bank draft in favour of national health insurance scheme. Vcship is gradually phasing out giving way for the NMHIP (national mobile health insurance program) which is inconjonction with the mobile communication industry like mtn etc.
3. Tertiary social health insurance programme is for students in tertiary institutes.
4. Community based social health insurance programme is for community's such as villages, market people, and groups with a member of 1000 people and above.
5. Pupil in public primary school social health insurance programme for students in public primary sch.

For any private organisation that may want to key into NHIS you can call me on 07030410822 (ikeja office)

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Re: Nhis(national Health Insurance Scheme) by upmanagers: 3:28pm On Jul 08, 2014
I have been a little busier which is why I have not updated on this topic.
But I see their is No question or comment, does it mean Nairaland health section knows so much about NHIS?
Re: Nhis(national Health Insurance Scheme) by upmanagers: 3:44pm On Jul 09, 2014
There are 3 levels of care in NHIS.
1. Primary health care providers- they act as first point of contact and gate keepers. In other words, when choosing a facility, every enrollee has a choice to chose a primary health care provider(hospital). The primary healthcare has about 70% cases yearly.
2. Secondary health care providers- contact with them is through referrals via primary provider.
3. Tertiary health care providers- entry is through referrals via primary and/or seconary providers.

I will go on to discuss enrollee benefit packages, which people are eligible for each programme and how to register

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Re: Nhis(national Health Insurance Scheme) by theplanmaker: 12:27am On Jul 10, 2014
Thanks for the info,....For the formal, is there an age limit for the children? then for the vcship, will the plan cover me if I'm treated in a private hospital or community health center? do I av to pay any percentage of my bills?
Re: Nhis(national Health Insurance Scheme) by upmanagers: 7:37am On Jul 10, 2014
theplanmaker: Thanks for the info,....For the formal, is there an age limit for the children? then for the vcship, will the plan cover me if I'm treated in a private hospital or community health center? do I av to pay any percentage of my bills?

Formal covers employee, spouse and 4 biological children under the age of 18years.
For vcship as well as all other NHIS programmes, as long as you choose an NHIS accredited hospital, you only make 10% co-payment of your drugs, dripes, injections after treatment.
NHIS has private hospitals , general hospitals and community health centers in its accredited list, look out for NHIS posters in any hospital to be sure they are NHIS accredited or go any NhIS office.

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Re: Nhis(national Health Insurance Scheme) by upmanagers: 10:21am On Jul 14, 2014
Summary of Benefit package of NHIS include;
• Out-patient care, including necessary consumables(drugs, injection,dripe)
• Prescribed drugs, phamaceutical cares and diagnostic tests as contained in the NHIS essential drugs list and diagnostic test list
• Maternity care for up to four (4) live births for every insured contributor/ couple in the formal sector programme. »Additional care if any stillbirth.
• All live births eligible to cover will be covered during the post-natal period of twelve (12) weeks from the date of delivery.
• All perterm/ prematured babies eligible to cover shall be covered for twelve (12) weekss from the date of delivery
• Preventive care including immunisation as it applies in the National immunisation programme, Health education, Family planning(counceling), antenatal and post_natal care. » Adult immunisation viz HPV, hepatitis
• Consultation with specialist such as physicans, pediatrics, obstetricans, gynaecologiste, general surgeons, orthopedics surgeon, ENT, dental surgeons, radiologists, psychiatrics, ophthamologists and physiolotherapists etc
• Hospital care in a standard ward for a stay limited to cumulative of 21days per year
• Eye examination and care, the provision of low priced spectacles but excluding contact lenses
• All ophthalmological cases that cannot be handled at the primary level except those requiring tertiary care or on the exclusion list
• A range of prostheses (limited to artificial limbs produced in nigeria)
• Priventive dental care and pain relief (including consultation, dental Health education, amalgam filling and simple extraction)
• Root-canal treatment (maximum of 2 treatments).

next time if there is no question(s) I will enlighten us about NHIS enrollees' beneficiary rights

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Re: Nhis(national Health Insurance Scheme) by aghaibiam(f): 7:03pm On Jul 19, 2014
Thanks for your educative post.

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Re: Nhis(national Health Insurance Scheme) by Iyabetajos(f): 12:22am On Jul 20, 2014
thanks for educating us.pls i want to know what type of infertility treatments nhis covers
Re: Nhis(national Health Insurance Scheme) by upmanagers: 1:42pm On Jul 21, 2014
aghaibiam: Thanks for your educative post.
Thank you.
Iyabetajos: thanks for educating us.pls i want to know what type of infertility treatments nhis covers

Am not sure of the question but hope this answers it.
• Out-patient care, including necessary consumables(drugs, injection,dripe)
• Prescribed drugs, phamaceutical cares and diagnostic tests as contained in the NHIS essential drugs list and diagnostic test list
• Health education
• Consultation with specialist such as gynaecologiste
I will also advice you to have your HMO phone number so you can call anytime you are stock to ask if for directives.

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Re: Nhis(national Health Insurance Scheme) by Blessedmum(f): 9:06pm On Jul 21, 2014
upmanagers:
Thank you.


Am not sure of the question but hope this answers it.
• Out-patient care, including necessary consumables(drugs, injection,dripe)
• Prescribed drugs, phamaceutical cares and diagnostic tests as contained in the NHIS essential drugs list and diagnostic test list
• Health education
• Consultation with specialist such as gynaecologiste
I will also advice you to have your HMO phone number so you can call anytime you are stock to ask if for directives.
As regards infertility,I called our hmo's no but he said Nhis doesn't cover infertility.

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Re: Nhis(national Health Insurance Scheme) by upmanagers: 11:51am On Jul 23, 2014
Blessedmum:
As regards infertility,I called our hmo's no but he said Nhis doesn't cover infertility.

1. Hope you are already covered with an nhis programme (not private hmo).
2. If the service you needed was included in any of my earlier post then we need to take it up and make sure u get easy and quality healthcare. Please visit any of our offices as I earlier posted and make a formal complain.
Are you in lagos? I am in ikeja.
Re: Nhis(national Health Insurance Scheme) by wola44: 2:22pm On Jul 23, 2014
Does your NHIS cover private hospital ?
Re: Nhis(national Health Insurance Scheme) by Gboliwe: 4:49pm On Jul 23, 2014
wola44: Does your NHIS cover private hospital ?
NHIS cover most private hospitals
Iyabetajos: thanks for educating us.pls i want to know what type of infertility treatments nhis covers
No, NHIS does not cover the treatment of infertility
Re: Nhis(national Health Insurance Scheme) by Iyabetajos(f): 10:02pm On Jul 23, 2014
[quote author=Gboliwe] NHIS cover most private hospitals
No, NHIS does not cover the treatment of infertility

what about
diagnostic tests like abdominal scan

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Re: Nhis(national Health Insurance Scheme) by Gboliwe: 6:33am On Jul 24, 2014
[quote author=Iyabetajos][/quote] yes it does.
Re: Nhis(national Health Insurance Scheme) by Uricas(m): 12:16am On Jul 27, 2014
I'm a student but not in school currently. I need to see a doctor asap. Can I go to the health centre in my area with the NHIS card given in school? Is there any possibility that I will be able to see a doctor as they are on strike? Thanks in anticipation.
Re: Nhis(national Health Insurance Scheme) by Gboliwe: 2:30pm On Jul 27, 2014
Uricas: I'm a student but not in school currently. I need to see a doctor asap. Can I go to the health centre in my area with the NHIS card given in school? Is there any possibility that I will be able to see a doctor as they are on strike? Thanks in anticipation.
If you have an emergency condition, you can use any NHIS accredited facility across the country.
Re: Nhis(national Health Insurance Scheme) by Uricas(m): 6:20pm On Jul 27, 2014
Gboliwe: If you have an emergency condition, you can use any NHIS accredited facility across the country.
thanks.
Re: Nhis(national Health Insurance Scheme) by Blessedmum(f): 10:54pm On Aug 03, 2014
upmanagers:

1. Hope you are already covered with an nhis programme (not private hmo).
2. If the service you needed was included in any of my earlier post then we need to take it up and make sure u get easy and quality healthcare. Please visit any of our offices as I earlier posted and make a formal complain.
Are you in lagos? I am in ikeja.
Thanks for the response.I do not understand what u meant by private hmo,all I know is dat we're serviced by Nhis thru my place of work.I demanded for reference letter to an Nhis gynaecology but was denied by d Nhis doctor posted to my office.
Infact we av a lot of complaint against him and I wish there is an avenue to do that.
As regards going to your office,please do u av any in Abeokuta?That is my present location. Thanks.
Re: Nhis(national Health Insurance Scheme) by upmanagers: 3:53pm On Aug 04, 2014
Blessedmum:
Thanks for the response.I do not understand what u meant by private hmo,all I know is dat we're serviced by Nhis thru my place of work.I demanded for reference letter to an Nhis gynaecology but was denied by d Nhis doctor posted to my office.
Infact we av a lot of complaint against him and I wish there is an avenue to do that.
As regards going to your office,please do u av any in Abeokuta?That is my present location. Thanks.

You are welcome.
Abeokuta office: 13 Adetokunbo ademola cresent, GRA ibara housing estate, abeokuta.
When I said private HMO I mean HMO private plan. Am guessing you work with federal government that is why you don't understand the term.

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Re: Nhis(national Health Insurance Scheme) by kavey10(m): 6:05am On Aug 05, 2014
Uricas: I'm a student but not in school currently. I need to see a doctor asap. Can I go to the health centre in my area with the NHIS card given in school? Is there any possibility that I will be able to see a doctor as they are on strike? Thanks in anticipation.

@upmanagers, please answer this question. I need a satisfactory response. Thanks
Re: Nhis(national Health Insurance Scheme) by upmanagers: 9:21am On Aug 05, 2014
kavey10:

@upmanagers, please answer this question. I need a satisfactory response. Thanks

Yes, you can go to any NHIS accredited hospital anywhere in Nigeria with your NHIS card for treatment but it is only on emergency cases. It will also be wish to have your hmo phone number(s).
Re: Nhis(national Health Insurance Scheme) by Uricas(m): 10:05am On Aug 05, 2014
upmanagers:

Yes, you can go to any NHIS accredited hospital anywhere in Nigeria with your NHIS card for treatment but it is only on emergency cases. It will also be wish to have your hmo phone number(s).
Emergency case like I'm sick and need to see a doctor? what's d meaning of hmo?
Re: Nhis(national Health Insurance Scheme) by Gboliwe: 12:32pm On Aug 05, 2014
Uricas:
Emergency case like I'm sick and need to see a doctor? what's d meaning of hmo?
Yes, emergency case like you are sick, had an accident that needs urgent medical attention.

Health
Management
Organisation.
These organisation deals directly with NHIS and the patients (enrollees). They are the middle man organisation. To get to NHIS, you paSs through them. For NHIS to reach enrollees, they pass through the HMO.

What school are you in, maybe I could help find out the HMO that covers your school so you can reach them for more private talk.
Re: Nhis(national Health Insurance Scheme) by Uricas(m): 4:57pm On Aug 05, 2014
Gboliwe: Yes, emergency case like you are sick, had an accident that needs urgent medical attention.

Health
Management
Organisation.
These organisation deals directly with NHIS and the patients (enrollees). They are the middle man organisation. To get to NHIS, you paSs through them. For NHIS to reach enrollees, they pass through the HMO.

What school are you in, maybe I could help find out the HMO that covers your school so you can reach them for more private talk.
Thanks for the reply. I'm in Obafemi Awolowo University.
Re: Nhis(national Health Insurance Scheme) by kavey10(m): 5:44pm On Aug 05, 2014
upmanagers:

Yes, you can go to any NHIS accredited hospital anywhere in Nigeria with your NHIS card for treatment but it is only on emergency cases. It will also be wish to have your hmo phone number(s).

I will do so. Thanks for the reply.
Re: Nhis(national Health Insurance Scheme) by kavey10(m): 5:46pm On Aug 05, 2014
Gboliwe: Yes, emergency case like you are sick, had an accident that needs urgent medical attention.

Health
Management
Organisation.
These organisation deals directly with NHIS and the patients (enrollees). They are the middle man organisation. To get to NHIS, you paSs through them. For NHIS to reach enrollees, they pass through the HMO.

What school are you in, maybe I could help find out the HMO that covers your school so you can reach them for more private talk.

Sir, mine is UNIBEN. Thanks.
Re: Nhis(national Health Insurance Scheme) by Gboliwe: 7:21pm On Aug 05, 2014
kavey10:

Sir, mine is UNIBEN. Thanks.
Uricas:
Thanks for the reply. I'm in Obafemi Awolowo University.

Do you have a health identity card?
Re: Nhis(national Health Insurance Scheme) by kavey10(m): 8:19pm On Aug 05, 2014
Gboliwe:

Do you have a health identity card?

Yes, I do.
Re: Nhis(national Health Insurance Scheme) by Uricas(m): 9:52pm On Aug 05, 2014
Gboliwe:

Do you have a health identity card?
yes

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Re: Nhis(national Health Insurance Scheme) by Gboliwe: 11:50pm On Aug 05, 2014
Uricas:
yes

Lol. Then you have your hmo's identity already. Just read through the card to know what organisation is covering you.
kavey10:
Yes, I do.
Re: Nhis(national Health Insurance Scheme) by Uricas(m): 6:41am On Aug 06, 2014
Gboliwe:
Lol. Then you have your hmo's identity already. Just read through the card to know what organisation is covering you.
yeah, got that already.

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