Edo State Health Insurance Commission has stated its commitment to providing universal health coverage for all citizens and residents of the state without segregation and at pocket-friendly rates.
The Director General of the Commission, Dr. Rock Ilelosa Amegor, stated this in an exclusive interview with The Nigerian Observer in his office in Benin City, the Edo State capital.
Dr. Amegor explained that the health insurance scheme being run by the Commission is open to all citizens and residents of Edo State and not reserved for just government workers.
“Every time you hear of health insurance, it sounds very elitist. You hear people say, ‘It is only for those that are educated or those working within the government’. If you see the percentage of those working within government, it’s about 20 per cent of the total coverage we have today. The bulk of the people that exist are outside, the non-government workers,” Dr. Amegor said.
He said the Commission only had to start covering the government workers first because of ease of access, explaining that each Edo State worker has 1.75 per cent deducted from their gross salary to cover for health insurance.
But even that, he said, is not enough to cover for the workers’ health care.
“And so, the Obaseki government was magnanimous to say whatever an enrollee pays for health care, we will match it. So if, for example, you are contributing N5,000 to the health insurance, the governor is also contributing another N5,000 on your behalf,” Dr. Amegor said.
“So, if you look at Grade Level 11 down to 17, those who are on a higher cadre, they contribute more because of the percentage base, but those who are on the lower cadre – cleaners drivers, etc – contribute less but also get the same amount of care. So we don’t get to say because you’re in Grade Level 3, go to a particular hospital.
“So, it’s health care across everybody, universal health care, and it can cover father, mother and four children less than 18 years of age. That’s for those working within the government’s purview.
“Now, if you’re not an employee of the government, you’re an individual, we have plans ranging from N18,000 to N75,000. The Bronze plan is N18,000, the Silver plan is N35,000, the Gold plan is N68,000, and the Platinum is N75,000. For all these plans, as they are increasing, your benefits are increasing,” he said.
Speaking further, the Director General stated that one of the goals of the Commission is to make the health insurance scheme inclusive in terms of people who provide care, from primary level care to secondary level care to pharmaceutical care, diagnostics and all cadres of care, to ensure that all enrollees get access to premium health care.
“What the health insurance is doing is trying to consolidate most of these health schemes to bring them under one roof, if you like, such that the services they give across board will be standardized. The pricing of services will be standardized. A lot of people can now get health care by paying a minimal amount of premium into our scheme, and they get better health care. So it’s an all-inclusive process,” Dr. Amegor said.
“And to make it more inclusive, we did implementation research, we saw that a lot of facilities, what they do is that they say they have stock out. So drugs that are primary, we pay the facilities on time. If you are an enrollee, whether you are sick or not, we pay the facility on your behalf monthly. It’s called capitation,” he said.
He further said that measures have been put in place to guarantee that premium services are given to the enrollees as the commission is geared towards patient-centric care, ensuring that enrollees go home feeling satisfied with a positive experience anytime they visit most of the facilities.
He emphasized ways the Commission checkmates the health providers and their claims at the end of every month even down to as little as drug dispensation.
