The National Health Insurance Authority (NHIA) has started the automatic migration of all contributors to the Social Security and National Insurance Trust (SSNIT) onto the National Health Insurance Scheme (NHIS).

This is to ensure that all SSNIT contributors, whose 2.5 per cent deductions are used to fund the NHIS, become automatic subscribers to the scheme.

Once their premiums are covered by SSNIT, the authority does not need to wait for them to voluntarily sign on to the mutual health insurance scheme.

The acting Chief Executive Officer (CEO) of the NHIA, Dr Da-Costa Aboagye, who disclosed this to journalists in Koforidua last weekend, said bringing SSNIT members, who were the second largest contributors to the health insurance fund, was one of four innovations the NHIA was pursuing to ensure the country achieved Universal Health Coverage (UHC).

The others are expanding the scheme to visitors, formalising the system, improving the benefits with the introduction of the once a year checkup and ending illegal charges such as co-payments.

This was during a media and stakeholder engagement. Aside from selected key media, also present were representatives of the Ghana Armed Forces, the Ghana Police Service, the Ghana Immigration Service, the Ghana Prisons Service, the Ghana National Fire Service, the Ghana Medical Association, Private Health Facilities Association of Ghana, traditional authorities, the Board Chairman of NHIA, Dr Ernest K. P. Kwarko, and some directors and staff of the NHIA.

It was to have a frank discussion about the NHIS, the achievements and its strategic plans going forward.

Explanation

Dr Aboagye explained that data obtained from SSNIT indicated that there were about 2.3 million contributors to SSNIT whose deductions to NHIS were being made religiously.

However, only about one million had subscribed to the NHIS, leaving about 1.3 million SSNIT contributors out of the coverage of the health insurance scheme, the CEO said.

Furthermore, out of the one million NHIS subscribers, only about 650,000 were active users of their cards, with more than 400,000 SSNIT contributors being inactive NHIS members.

Dr Aboagye said in collaboration with the National Identification Authority (NIA) and SSNIT, the NHIA was now able to link the SSNIT contributors to their Ghana Cards which was being used for the automatic migration to make them NHIS subscribers.

The NHIA CEO said the one-month period of waiting when one signed on to the NHIS scheme had also been waived for SSNIT contributors, while they would also not have to pay any amount to become first-time subscribers.

Subsequently, the NHIA had been sending messages to all SSNIT contributors who are also subscribers of the NHIS, informing them of the automatic renewal of their membership when it expired in order to keep them perpetually on the scheme.

Removing barriers

Removing those barriers, Dr Aboagye said, was the way to go in achieving the universal health coverage which should happen by 2030. “Deductions are made from all SSNIT contributors towards NHIS, yet they pay GH¢8 to register. 4

“This is a barrier, and the board has decided to take it away and automatically sign them on to have automatic access to the NHIS,” Dr Aboagye stated.

The CEO also explained the barrier removals would also extend into the informal sector, as well as children between the ages of six and 14 years.

“The Ghana Card holds the key to realising the UHC,” Dr Aboagye said, adding that the board had also taken the decision to formalise the informal sector’s participation in the NHIS by making the Ghana Card the only card to be used for subscribing onto the scheme.

He said while the NHIS cards with five-year expiry date cost between $4 and $6, the Ghana Card with a 10-year expiry period cost between $6 and $7.

It was, therefore, better to make the Ghana Card the primary identity management tool for the scheme to encourage subscription, while enabling the about 28 million existing subscribers with many expired and inactive cards to stay active on the scheme, Dr Aboagye explained.

“The card and the premiums subscribers pay contribute less than three per cent of our budget. Hence, removing the barrier to subscription by making the Ghana Card the medium for joining would help achieve the UHC faster,” the CEO of NHIA stated.

Identity management space

While birth registry by the Ghana Health Service and the Births and Deaths Registry occurs for infants aged between zero and five years, and the Ghana Card covering teenagers from 15 years and above, the only group left from the identity management space is children between six years and 14 years.

That had informed the NHIA to cede its card printing duties to the NIA so that subscribers could obtain the Ghana Card once and also use it as their NHIS membership cards, with their medical information imbedded in it.

To remove barriers to ages six-14 group signing on to the NHIS, the NHIA has liaised with the NIA to issue Ghana Cards to all such persons, with the pilot scheduled to start in five districts shortly.

Preventive, health promotion

Dr Aboagye said since its 20-year existence, the NHIS had focused on curative health services, but it was time to incorporate the preventive healthcare claims.

He said a committee was working on the preventive health system, where subscribers would be encouraged to go for health check-ups once a year, for a start, in order to diagnose ailments early for treatment before they became acute or chronic, which put more impact on the scheme.

Dialysis

Throwing light on the authority’s recent announcement to pick up the cost for dialysis patients, Dr Aboagye described it as an important intervention which respected no party colours.

In a correspondence informing the facilities about the benefit package, the NHIA added a claims form to ensure that anybody who paid for the service any day within the first week of implementation would be reimbursed.

“Management of the NHIA reiterates that under this programme, the patients shall not be charged for dialysis treatment per the benefit package stated above. Kindly note that should the patient be charged, the authority shall reimburse the patient after all necessary reconciliations have been concluded upon claims submission,” the NHIA boss wrote.