FREQUENTLY ASKED QUESTIONS AND THEIR ANSWERS ON THE DELTA STATE CONTRIBUTORY HEALTH SCHEME
COURTESY:DELTA STATE CONTRIBUTORY HEALTH COMMISSION (DSCHC)
10, DBS ROAD,
1. WHAT IS THE NEW HEALTH SCHEME?
The new health scheme is the ‘Delta State Contributory Health Scheme’. It is a contributory social health insurance scheme that aims at providing access to quality and affordable health care service to all residents in Delta State.
2. WHO IS COVERED BY THE NEW HEALTH SCHEME?
By law, the ‘Delta State Contributory Health Scheme’ covers every person who is resident in Delta State.
3. IS THE NEW HEALTH SCHEME MANDATORY FOR ALL CATEGORIES OF EMPLOYERS AND EMPLOYEES COVERED UNDER THE LAW?
The new health scheme is mandatory for all categories of employers and employees whose organization has in its employment 10 persons and above. These category of persons fall under the formal sector group as provided for in the Delta State Contributory Health Scheme law.
4. WHAT IS THE MAIN OBJECTIVE OF THE DELTA STATE CONTRIBUTORY HEALTH SCHEME?
The main objective of the health scheme is to provide access to quality and affordable healthcare service to all residents in Delta State. Everyone who contributes into the Pool of Funds and goes to the Hospital when ill will receive care without paying any money at the hospital.
5. HOW MUCH WILL AN EMPLOYEE CONTRIBUTE INTO THE SCHEME?
An employee shall make a monthly contribution of 1.75% of the total of his/her monthly gross salary into the scheme as part of his/her premium. This will cover the employee, spouse and 4 children under 18years.
6. WILL THE EMPLOYER ALSO CONTRIBUTE?
The Employer shall also contribute another 1.75% of the Employee’s monthly gross salary to complete the premium on behalf of each Employee.
7. WHAT NEXT AFTER CONTRIBUTING?
During the process of contributing, your bio-data details will be collected to register you into the Scheme. Your payment details will then be linked to your registration details after which an IdentityCard will be issued to you. Also the list of accredited healthcare facilities available to you will be shown for you to select from the healthcare facilities close to your residence.
Finally the list of enrollees will be sent to the healthcare facilities along with the capitation payment for those assigned to the healthcare facility and this will entitle them to visit the healthcare facilities when they are ill. This process along with other administrative and compliance processes takes 60 – 90 days.
8. IF I GET TO THE HOSPITAL AND I AM NOT ATTENDED TO OR I AM POORLY ATTENDED TO, WHAT SHOULD I DO?
When you get to the hospital and you are not properly attended to, you are to immediately call the Commission 24 hours Call Center who shall then take the necessary action as required by the law. The Call Center numbers will be published and pasted at each healthcare facility.
9. AFTER CONTRIBUTING AS A PUBLIC SERVANT, IF I RETIRE FROM SERVICE AND HAVE NOT GONE TO HOSPITAL WHILE IN SERVICE, AM I ENTITLED TO ANY REFUND FROM THE MONEY I CONTRIBUTED?
The health scheme is a social insurance scheme, and it is not for serving Public Servants alone. You are covered in the Scheme even after retiring from service, as long as you are alive and resident in Delta State.
10. IF AN ENROLLEE IS NOT SATISFIED WITH THE SERVICES OF HIS/HER CHOSEN HOSPITAL, CAN HE/ SHE CHANGE TO ANOTHER HOSPITAL?
Yes an enrollee who is not satisfied with the service he/she gets from a hospital can change to another hospital. He/She shall first report the issue to the Commission who shall investigate and if found to be true, the commission shall send the enrollee to another hospital.
11. WHAT IS THE FATE OF A COUPLE WHO’S HUSBAND/WIFE IS A FEDRAL WORKER AND ARE PRESENTLY ENROLLED WITH NHIS?
If you are already properly covered in the NHIS Scheme, you will be exempted from the DSCHS Scheme after you show proof of it. But note that you will only attend healthcare facilities under NHIS and not the DSCHS.
12. WHAT IS THE DIFFERENCE BETWEEN DSCHS AND NHIS?
NHIS is a federal Scheme while DSCHS is a State only Scheme. The NHIS is represented in the DSCHS Board and thus they both have a collaborative relationship.
13. IT IS A KNOWN FACT THAT THE HEALTHCARE FACILITIES ARE DEFICIENT BOTH IN MANPOWER AND FACILITY. WHAT IS THE COMMISSION DOING TO BRIDGE THE GAP?
Only healthcare facilities that meet the service level criteria of the DSCHS in terms of manpower, equipment and quality of service will be accredited to provide service under the Scheme.
FREQUENTLY ASKED QUESTION ON THE
MANAGEMENT OF THE HEALTH SCHEME.
1. HOW DO PEOPLE CONTRIBUTE INTO THE SCHEME?
Monthly or Yearly. However a daily or weekly contribution arrangement can be in place for certain category of people. This applies to those under the informal sector.
2. HOW IS THE HEALTH SCHEME TO BE REGULATED?
The Scheme will be regulated by the Delta State Contributory Health Commission in line with the Law of the Commission.
3. WHAT ARE THE MAIN FUNCTIONS OF THE DELTA STATE CONTRIBUTORY HEALTH COMMISSION?
The Commission will Regulate, Implement and Supervise the processes required to deliver the mandate of the Scheme which is to ensure access to quality and affordable healthcare services for all residents of Delta State irrespective of their socioeconomic status in the State. The main functions of the Commission are as listed in the Law which is available at the Commission website www.dschc.org.ng.
4. WHAT IS A HEALTH CARE FACILITY (HCF) UNDER THE SCHEME?
A healthcare facility under the Scheme is a public or private place accredited by the commission to provide healthcare service.
5. HOW DO I KNOW WHICH HEALTH CARE FACILITY TO CHOOSE?
The list of accredited healthcare facility to choose from will be published and will also be available during registration.
6. HOW IS THE HEALTH CARE FACILITY GOING TO BE PAID?
The Commission will pay healthcare facilities through upfront capitation or Fee for Service payment system.
7. WHAT IS THE ROLE OF THE HMOs IN THIS HEALTH SCHEME?
The role of HMOs will be as stated in the Law of the Commission. They will ensure that quality service is provided by healthcare facilities for the benefit of the patient.
9. CAN AN EMPLOYER WHO IS ALREADY IN A HEALTH INSURANCE SCHEME BE ALLOWED TO MAINTAIN THE EXISTING SCHEME AND CHOOSE NOT TO ENROLL WITH DSCHS?
Such a Scheme will have to enroll its member under the DSCHS and comply with requirements to operate in Delta State.
10. WHAT IS THE REQUIREMENT FOR THE ACCREDITATION OF A HMO?
The requirements for accreditation are listed in the DSCHC law. The process is to ensure that the HMOs will comply with the standard of service required to participate in the DSCHS.
11. HOW WILL THE DSCHC ENSURE THAT THE HEALTH CARE FACILITIES DO THE RIGHT THING AND PROVIDE QUALITY CARE?
The Law and the operational guideline will specify actions and penalties for breach of the Service Level Agreement that the Commission will have with each accredited Health Care Facility and HMO. There will also be a monitoring and evaluation team to ensure compliance.
FREQUENTLY ASKED QUESTION ON ISSUES OF
GOOD GOVERNANCE AND INTEGRITY OF THE NEW SCHEME.
1. HOW CAN I BE SURE THAT MY CONTRIBUTIONS ARE SAFE?
The Financial Management System in place for the Scheme as stated in the Law, is to ensure that contributions are kept in safe banks with an expenditure and investment processes that will comply with financial regulatory standards that safeguards the funds contributed.
2. WHAT IS THE GUARANTEE THAT GOVERNMENT WILL CONTRIBUTE THEIR PART AS AT WHEN DUE?
The Political Will and Integrity of the Government administering the State is the first guarantee. The second guarantee is the Law establishing the commission which clearly states the requirement that the employer must contribute at the least a part of the contribution for the employee.
3. IF GOVERNMENT FAILS TO CONTRIBUTE THEIR PART AS AT WHEN DUE, WILL THAT STOP ME FROM GETTING SERVICE FROM THE HCFs?
No and the Commission will also ensure that employers make their contribution for their employee in compliance with the Law of the Commission.
4. WHAT IS THE ROLE OF GOVERNMENT IN THE NEW HEALTH SCHEME?
The Government is a facilitator and a safeguard for the Scheme. The Scheme is a Government/Private Social Investment program for improved access to quality and affordable healthcare services for all.
5. CAN THE GOVERNMENT TAKE OR USE THE MONEY IN THE HEALTH SCHEME POOL FOR ANY OTHER PURPOSE?
No. The law clearly specifies the expenditure and investment activities for the Scheme. Any activity outside that will be a breach of the law.
6. IS THERE ADQUATE REPRESENTATION OF ALL STAKEHOLDERS ON THE BOARD OF THE COMMISSION?
Yes all stakeholders especially those that have investment interest are represented in the Board of the Commission and majority are non-government appointees.
7. DOES THE DELTA STATE CONTRIBUTORY HEALTH SCHEME LAW REFLECT THE APPLICATION OF THE PRINCIPLES OF TRANSPARENCY AND ACCOUNTABILITY?
FREQUENTLY ASKED QUESTIONS ON
THE BENEFITS OF THE NEW HEALTH SCHEME.
1. WHAT ARE THE BENEFITS OF THE HEALTH SCHEME?
Improved access to quality and affordable Basic Minimum Benefit Healthcare Package services irrespective of your socioeconomic status if you are a resident of Delta State and enrolled in the Scheme. TheBasic Minimum Benefit Healthcare Package service list will be published in the Operational Guideline for the Scheme and made available to all enrollees and Healthcare Facilities.
2. WHAT ARE THE DIFFRENT HEALTH PLANS UNDER THE SCHEME?
The Equity Health Plan for the vulnerable people resident in Delta State. This plan will cover all pregnant women, children under 5 years, the elderly and the physically and mentally challenged that cannot afford to pay for their contribution.
The formal Health Plan for Public and Organized Private Sector Workers resident in Delta State. This plan will cover all workers with 10 or more employees in the public and private organizations with a payroll system.
The Informal Health Plan for the Informal Sector Workers resident in Delta State. This plan will cover others people not covered in any of the plans listed above. This will include amongst others, the members of the various trade associations.
Private Health Plan for those resident in Delta State and enrolled in the Scheme and want extra healthcare services on top of what is provided in the Basic Minimum Benefit Healthcare Package.
3. WHAT AILMENTS CAN BE TREATED UNDER EACH HEALTH PLAN?
The ailments that can be treated under the Scheme are as stated in the Basic Minimum Benefit Healthcare Package stated in the Gazetted Operational Guideline of the Commission. There will be one BasicMinimum Benefit Healthcare Package for all Health Plans and an extra Benefit Healthcare Package for the Private Health Plan.
4. CAN I INCREASE MY BENEFIT BY UPGRADING MY HEALTH PLAN?
Yes through the Private Health Plan.
For further enquires please send text or whatsapp messages to08187488485, 09060081515, and 09029039082.