National Health Insurance Authority; Membership And Registration

The National Health Insurance Authority is a corporate body that seeks to attain a universal health coverage in relation to

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persons resident in Ghana
persons not resident in the Ghana but who are on a visit to the country
and to provide access to healthcare services to the persons covered by the Scheme.

What are the functions of the authority?

For the purposes of achieving its objective of providing universal and quality health to Ghanaians, the Authority may

Implement, operate and manage the National Health Insurance Scheme
Determine in consultation with the Minister contributions that should be made by members of the National Health Insurance Scheme;
Register members of the National Health Insurance Scheme;
Register and supervise private health insurance schemes
Issue identity cards to members of the National Health Insurance Scheme
Ensure equity in health care coverage
Ensure access by the poor to healthcare services
Ensure protection of the poor and vulnerable against financial risk
Grant credentials to healthcare providers and facilities that provide healthcare services to members of the National Health Insurance Scheme
Manage the National Health Insurance Fund
Provide a decentralized system to receive and resolve complaints by members of the National Health Insurance Scheme and healthcare providers
Receive, process and pay claims for services rendered by healthcare providers
Undertake public education on health insurance on its own or in collaboration with other bodies
Make proposals to the Minister for the formulation of policies on health insurance
Undertake programmes that further the sustainability of the National Health Insurance Scheme
Develop guidelines, processes and manuals for the effective implementation and management of the National Health Insurance Scheme
Ensure the efficiency and quality of services under the national and private health insurance schemes
Protect the interest of members of private health insurance schemes
Identify and enrol persons exempt from payment of contribution to. National Health Insurance into the National Health Insurance Scheme
Monitor and ensure compliance with this Act and any Regulations, guidelines, policies, processes and manuals made under this Act for National Health Insurance.
Perform any other function conferred on it by this Act or that are ancillary to the obj.ect of the Authority.

What benefits do you get from registering with the authority?

The National Health Insurance Authority provides a range of paid healthcare services to its members. They are listed below;

Out Patient Services

The scheme covers consultations including reviews of conditions that are treated at outpatient setting which are;

Malaria, acute respiratory tract infection, diarrhoeal disease, skin disease and ulcers, hypertension, acute eye infection, rheumatism, anaemia, intestinal worms disorders, acute ear infection, typhoid fever, dental caries, diabetes mellitus, STIs, asthma and others (general and specialist)
Investigations, including laboratory investigations, x-rays
ultrasound scans for general and specialist out-patient services.
HIV/AIDS symptomatic treatment for opportunistic infections.
Out-patient/day surgical operations, including hernia repairs, incision and drainage of abscesses, and excision of lumps and haemorrhoidectomy.
Out-patient physiotherapy.
Medication, namely, prescription medicines on the National Health
Insurance Scheme Medicines List, traditional medicines approved by the Food and Drugs Board and prescribed by accredited medical and traditional medicine practitioners.
Any other services approved by the Minister of Health.

Oral Health

The authority caters for oral health services like;

Pain relief, which includes incision and
Drainage, tooth extraction and temporary relief.
Dental restoration, which includes simple amalgam
Fillings and temporary dressing

Emergencies

All emergencies are covered. These are crisis health situations that demand urgent intervention and include:

Medical emergencies and surgical emergencies, including brain surgery or heart surgery due to accidents.
Paediatric emergencies.
Obstetric and Gynaecological emergencies including Caesarean sections.
Road Traffic Accidents.
Industrial and workplace accidents

Maternity Care

Maternity services catered for by the scheme are;

Antenatal care
Deliveries (normal and assisted)
Caesarean section
Post-natal care

In Patient Service

General and specialist in-patient care.
Investigations including laboratory
Investigations, x-rays and ultrasound scans for in-patient care.
Cervical and breast cancer treatment.
Diagnosis and complications from other cancers, e.g. anaemia or obstruction
Surgical operations, including appendicectomy (removal of the appendix).
In-patient physiotherapy.
Accommodation in general ward.

How do you become a member?

To register as a subscriber of NHIS, you will be interviewed to know which category you belong to, whether you are registering as:

An annual premium paying member, or
A member of the exempt group.

If you are registering as an annual premium paying member, please note that you will pay premium and processing fee once every year for renewal.

What processes do you follow to register?

At registration, the registration officer will assist you to fill a registration form. You will need to provide the following personal particulars;
Full name
Date of birth
Age
Marital status
Mobile phone number(s)
Community of residence.

After taking your personal particulars and payments, the registration officer will take your photograph and biometric information.
During the taking of your photograph, you should open your eyes and look straight into the camera. You should also close your mouth.
The biometric information required is fingerprints of your ten fingers. The prints will be taken in this order:The four fingers of your right hand,the four fingers of your left hand and your two thumbs.
During registration, you will be required to select your preferred primary provider (PPP).
The PPP should be a primary care provider, which should either be a clinic/health centre, polyclinic or a primary hospital. You should make the choice yourself otherwise you will be assigned to an available primary care provider.When you fall ill, you should first of all visit your PPP for treatment. If your illness cannot be treated at the primary care level, you will be referred to a higher level health care facility.
In an emergency, you may access health care at any health care facility.
You may change your PPP at determined intervals or when you change your permanent residence.
After registration, the district office will give you a list of health care facilities within your area operating under the NHIS

The article has concretely described the simple steps an individual can take easily to become a member of the National Health Insurance Scheme.