Health insurance critical in ensuring affordable healthcare to Nigerians

…as IHMS unveils Mega Health Insurance Plan

L-R; Jide Rotimi-Fadipe, Principal Manager, Finance and Admin; Chidi Ukandu, Chief Operating Officer and Wole Olomojobi, Chief Marketing Officer, all of International Health Management Services (IHMS), during the launch of the IHMS Mega Health Insurance Plan, at Lagos recently.

Over the years, the healthcare needs of Nigerians have been on a steady rise, leading to a situation whereby government-financed health services depend largely on out-of-pocket payment by patients. For some Nigerians who could not afford out-of-pocket payment at hospitals are left with an option of patronizing quacks and roadside drug vendors for medicare. 

 

Even in states where healthcare is free for the elderly, pregnant women and children under-five, many complain not having enough money for transport and other logistics. To address this, the Federal Government set up the National Health Insurance Scheme (NHIS) under Act 35 with the sole aim of ameliorating the health burden of Nigerians at an affordable cost through various prepayment systems.

 

While stakeholders in the health sector believe that health insurance as outlined by NHIS guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals, International Health Management Services (IHMS), a health management organisation has recently unveiled a new health plan (IHMS Mega Plan) for staff and dependants of local nationals and expatriates residing in the country access to boundary-less health insurance cover within Nigeria and beyond.

 

In an interview with BusinessDay, Chidi Ukandu, Chief operating Officer, revealed that insurance aims at protecting the individual from financial consequences of events with a low probability of happening but with the potential to cause substantial loss.

 

While stating that IHMS Mega Plan, which is a product reinsured by ICICI Bank/Lombard General Insurance of India, Ukandu noted that health Insurance is a social device for pooling the health risks and costs of an exposure unit with view towards predictability (the probability of illness is not low hence the actuarial determinations allow for more variance)

 

According to Ukandu, “IHMS Mega Plan gives everyone access to quality health services in Nigeria, India and other parts of the world. This is made possible through the synergy between our reinsurer (ICICI/Lombard General Insurance Company) and IHMS.  Our reinsurer would also assist IHMS in claims related to services to be provided to insured for treatment in India. Enrollees are set to enjoy cashless treatment in India (covers in-patient, out-patient, complex surgeries as prescribed by the healthcare provider or otherwise and worldwide emergency cover).

 

“In case an enrollee in the scheme needs a treatment in India, the insurance company will reimburse the return airfare for insured and a person accompanying up to N300, 000 . For routine visits to the hospitals and hospitalizations, IHMS shall pay directly to the enrollees’ hospital. All that is required is to authenticate the claims form (usually with the enrollee’s chosen hospital whenever the person visits for medicare). In cases of hospitalization or some specified procedure, the enrollees’ hospital is required to call the call center within 48 hours when the treatment is been administered,” Ukandu concluded.

 

 

 

 

Lending his view, Wole Olomojobi, Chief Marketing Officer, disclosed that this is the first time a boundary-less health insurance product is originating in the country.

 

While noting that the Mega Plan offers cashless access to some of the hospitals accredited in India by Joint Commission International(global leader in accrediting health organisations based on quality of healthcare and other parameters), Olomojobi maintained that the synergy between IHMS and their India partners was borne out of the influx of Nigerians to India for medicare which is expensive when compared to the health insurance platform which they stand to benefit from this product by enrollees’ paying a certain amount as premium.

 

In his words “the Premium is the amount charged by the insurance company with the promise to pay for any eventual “covered medical treatment” for the designated coverage. Consequently, health insurance makes it possible to substitute a small but certain cost (premium) for a large but uncertain loss (claim) under an arrangement in which the healthy majority compensate for the risks and costs of the unfortunate ill minority. For the IHMS Mega plan, there are two premium payment platforms for groups (for group size less than 50 and another group size more than 50). The payment platform is different based on the age group,” Olomojobi stated.

 

With health management organisations (HMOs) offer services to employees mainly in the formal sector, unverified reports put beneficiaries under this platform at about seven million Nigerians. This no doubt has left a greater number of Nigerians to still depend on out of pocket financing for healthcare.

 

In the light of this, stakeholders have tasked the Federal Government to focus on the Community Based Social Health Insurance (CB-SHIP) as the structural framework for taking the primary health care programme to the people at the grassroots level.

 

They have also urged the National Assembly to pay special attention to the full implementation of the National Health Insurance Act to accelerate the universal coverage of the scheme which was expected to have been attained by 2015.

 

According to Kayode Obembe, Vice Chairman/ Chief Executive, Premier Medicaid International (PMI), a HMO, “the present situation whereby only Federal Government employees were enjoying the National Health Insurance Scheme was not good enough. There is the need for administrators of the scheme to review its strategy to ensure that states and local governments take up health insurance for all their employees.”