The Ashanti Regional Head of the National Health Insurance Authority, Kwadwo Dwomoh, is advocating an upward adjustment of premium for health insurance registration and renewal.  

Registration cost under the health policy currently stands at GHS26 and GHS8 for adults and children respectively per year.

Speaking on Luv in the Morning on Luv FM, Mr. Dwomoh said an increment would help cater for the poor and also resolve financial challenges bedeviling the scheme.  

“Personally, I wish the amount is increased from 26 Ghana cedis. But I can’t tell how much it should be increased to,” he told host David Akuetteh. 

The health insurance scheme over the years has been faced with challenges of delayed and non-payment of claims to the service providers. 

According to the regional head, the NHIA presently has three months outstanding payments to settle. 

Extortion and Co-payment

Health Minister, Kwaku Agyemang Manu, at the 2023 Ghana Health Service Senior Managers Meeting expressed dissatisfaction and worry at some service providers under the health insurance scheme. 

He accused them of extortion at the expense of poor citizens who cannot purchase medications.

The sector minister cited instances where he had to pay for healthcare services out of his pocket despite being an NHIS subscriber. 

His experience reflects similar events encountered by many subscribers. 

While admitting the infractions, Kwadwo Dwomoh indicated some subscribers abuse the scheme, shifting in-between health facilities. 

“Some members don’t really wait to take their medications at a facility then they move to another hospital. They do not wait to exhaust payment for their prescriptions. It is abuse. This is causing stress in the coffers of the authority,” he said.  

The NHIA in 2022 established a nine-member committee to mitigate the impact of out-of-pocket payment (co-payment) on access to medical services.  

The committee replicated at the regional and district levels is responsible for reporting issues of co-payment to higher authorities for swift action.

Kwadwo Dwomoh says victims of extortions and co-payment can make formal complaints as 13 of such cases have so far been addressed with a potential discrediting service provider. 

“We sometimes visit facilities that have been reported to be engaging in extortion to retrieve all the monies and also discredit them the reports are continuous. If it gets to a point where they need to be prosecuted, we do so,” he said.   

NHIS covers most diseases, but not all medications

Benefit packages under the National Health Insurance Scheme have seen an increase with the recent inclusion being four childhood cancers. 

But certain medications for treating medical conditions may not be covered by the insurance package. 

Commenting on concerns where subscribers paid for medicines for diseases covered by the scheme, Kwadwo Dwomoh explained some diseases, although covered, could have their medication not listed under the benefit package. 

Meanwhile, the Ashanti regional branch of the NHIA is set to hold a campaign to advocate benevolent payment of registration fees for poor adults.