The National Health Insurance Authority (NHIA) of Ghana has released details of its Benefit Package, derived from Act 852.

This package, which covers 95% of diseases prevalent in the country, was determined based on epidemiological data from 2003 when the scheme was initiated.

The NHIA's Benefit Package offers a wide range of services across six major categories:

1. Out-Patient Services: Including general and specialist consultations, investigations (lab, x-ray, ultrasound scans), and medications.
2. In-Patient Services: Covering general and specialist in-patient care, investigations, and medications.
3. Oral Health Services: Providing pain relief, incision and drainage, tooth extraction, dental restoration, and temporary dressing.
4. Eye Care Services: Offering refraction, visual fields, A-Scan, keratometry, and cataract removal.
5. Maternity Services: Encompassing ante-natal care, normal and assisted deliveries, caesarean section, and post-natal care.
6. Emergency Services: Including medical emergencies, surgical emergencies due to accidents, pediatric emergencies, and obstetric and gynaecological emergencies.

However, the NHIA has also released an explicit exclusion list, detailing services not covered under the scheme:

1. Aesthetic Treatments
2. Dialysis for Chronic Renal Failure(interim programme in place)
3. Organ Transplantation
4. Orthopedics
5. Cancer Treatment (Other than Cervical, Breast Cancer & 4 Childhood Cancers)
6. VIP Ward Accommodation
7. Heart and Brain Surgery (Other Than Those Resulting From Accidents)
8. All Drugs Not Listed On NHIS ML
9. Medical Examinations for Visa Applications, Driving Licenses etc.
10. Diagnosis And Treatment Abroad
11. Mortuary Services
12. Immunizations
13. Treatment of Tuberculosis, Onchocerciasis, Buruli Ulcer, Trachoma
14. Mental Health Treatment
15. HIV Treatment

The NHIA emphasises that while the Benefits Package is implicit, these exclusions are explicitly stated to provide clarity to all stakeholders.

According to the NHIA this comprehensive coverage, coupled with clear exclusions, aims to provide Ghanaians with improved access to healthcare while managing the scheme's resources effectively.