1

Why should a lower level officer enjoy the same health plan as a higher level officer since their contribution is not the same?
Answer: The idea behind health insurance is for collection of contribution from a group of people to create a pool, where funds required for medical services will meet the needs of those who require it at that particular time. This improves the health outcome of the society by bridging the financial gap between citizen during medical challenges.

FREQUENTLY ASKED QUESTIONS

FREQUENTLY ASKED QUESTIONS

2

Which health facilities have secured an accreditation from the Commission?

Answer: Currently, a total of 50 facilities have been accredited in Egor, Oredo and Ikpoba Okha (This represent the metropolis). The target of the Commission is to accredit a total of 150 facilities across the eighteen LGAs before the end of 2021.

3

What happens when a formal public sector beneficiary retire? Will he or she still be entitled to health benefits? 

Answer: A retired civil servant shall remain under the formal sector health plan but his/her contribution shall be adjusted in line with the amount specified by the Commission. This is due to increased health needs and reduction in co-contributions. Premium payable by civil servants who have been on the Scheme for 10 years or more will be reviewed (especially if utilization is low and investment yield have increased for the Commission) for a possible premium reduction.

4

Why is there a two-month administrative wait period for enrollees under the formal sector health plan? 

Answer: There is a general Administrative wait time for all health plans except the equity health plan who go through series of processes before verification. In a survey carried out by the Commission, it was observed that many Health Insurance Programs suffer from over utilization due to adverse selection; a situation where beneficiaries do not disclose their actual medical state to the insurer at the point of enrollment, for example, a beneficiary with chronic kidney illness and requires dialysis as soon as possible, not informing the Health Insurer of his/her medical state. An administrative wait period of 60-90 days is used to mitigate against this adverse selection. The administrative wait period of two months enables the Commission to profile the principal and his/her beneficiaries, update enrollment data, allocate Healthcare facilities, Issue ID card to beneficiaries and provide health education based on the services that will be available to beneficiary

5

What do I do if I have an additional dependent to add to my health plan?
Answer:
To add additional dependents to your health plan, you will be required to pay a premium
top-up determined by the Commission

6

In a situation where both spouse are civil servants, will they be restricted to the same dependents?

Answer: In a case where both spouse are civil servants, they are entitled to four children under the
age of eighteen.
A household is defined under the Edo State Health Insurance Commission as Father,
Mother and Four Children.
Dependents shall be selected at the discretion of the principal beneficiaries

7

How do I become a Health Care Facility Provider?

Answer:

  1. Facility must be registered with the Edo State Ministry of Health and fully certified
  2. Secure appropriate accreditation with the Commission by meeting the required standard
  3. Sign contract with commission and abide by all terms and conditions specified in the contract.
  4. Be ready to provide services specified in the benefit package of the various health plans.
  5. Be ready to comply with the operational guideline of the scheme.
  6. Be ready to satisfy beneficiaries (Enrollees) 

8

What is the meaning of Premium?

Answer: This is the amount to be paid to buy a health plan from the insurance company.

It is the sum that an enrollee pays monthly, quarterly or annually according to their plan in return for the benefit package he/she gets from the insurance company

Health Insurance helps reduce out of pocket spending and pay for the cost of health care, especially in the event of a serious illness or injury that could be very expensive

An individual can buy an health insurance plan at the EDHIC office and accredited centres or through your Employer 

This is the amount to be paid to buy an Health Plan from the Insurance Company. It is the sum Enrollee pays monthly, quarterly or annually according to their plan to get Health benefits from the Insurance company.

Each principal enrollee is assigned his or her health care facility. But note that criteria for assigning facilities is proximity to residence address or office address

  1. A retired civil servant shall remain under the formal sector health plan but his/her

Contribution shall be adjusted in line with the amount specified by the commission.

This is due to increased health needs and reduction in co-contributions. Premium payable by civil servants who have been on the Scheme for 10 years or more will be

Reviewed for a possible premium reduction. 

i. Equity health plan; there shall be no waiting period before accessing care for residents registered under this plan.

ii. Student health plan; there shall be no waiting period before students can access care in the assigned facilities.

iii. Informal health plan; there shall be an administrative waiting period of sixty (60) days before beneficiaries under this health plan can access care.

iv. Formal health plan; there shall be an administrative waiting period of sixty (60) days before beneficiaries can access care.

v. Enhanced Private health plan; there shall be an administrative waiting period of 30 days before beneficiaries under this health plan can access care from health facilities assigned to them.

A. (Yes)

   Procedure for changing my health plan

   Enrollee who wishes to change his/her health plan shall;

i. Duly notify the commission (3) three months before the intended date of change.

ii. Provide the commission with the necessary information required to include his/her new health plan of choice.

N.B: Kindly note that the enrollee will bear the cost of the new production of I.D card.

A. (Yes)

       Procedure for changing of facility

i. The enrollee shall notify the commission 3 months before due date.

ii. The enrollee shall obtain a change of health care facility/update form from the commission, fill and attach a copy of his/her passport photograph along with a dully signed application letter.

A.

i. Be registered under the Edo State Ministry of Health with certificate

ii. Secure appropriate accreditation with the commission

iii. Ensure that their facilities (Hospital) is up to high standard

iv. Sign contract with commission and abide by all terms and conditions specified in the contract.

v. Be ready to provide services specified in the benefit package of the various health plans.

vi. Be ready to comply with the operational guideline of the scheme.

vii. Be ready to satisfy beneficiaries (enrollee)

You can reach us through;

i. Customer care number 08073060807

ii. Facebook: facebook.com/edohis

iii. Twitter: @edhic_edohis

iv. Gmail: edhic@edostate.gov.ng

The cost of the family plan depends on the plan you are buying. However, a 5% discount will apply for people purchasing health plan for family of 6.

i. Visit an accredited enrollment center.

ii. Fill an enrollment form.

iii. Select a health plan.

iv. Pay a premium.

v. Notification will be sent via SMS or email after enrollment.

vi. The date will be communicated to you for the pick-up of Insurance ID Card.

For the individual plan we have:

 * Student health plan

 * Formal health plan

 * Informal health plan. Under which we have bronze, silver and gold

* Enhanced private plan.

For the family plan, we have:

* Formal health plan.

*  Informal health plan. Under which we have the bronze, Silver and Gold plan.

Enhanced health plan.

To be an aggregator of EDHIC, you should:

* Visit the commission’s office.

* Apply to be an aggregator

* Information provided during application will be verified by the commission.

* Agreement will be signed after meeting the requirements

* Status of application will be communicated to the applicant.

To access care as an enrollee, simply visit the primary health facility assign to you, present your health Insurance Card and you will be attended to.

All health plan has different level of care for pregnant women

Equity Health plan is a special plan meant for the vulnerable which include Poor Pregnant women, Children Under 5, Aged, physically challenged and the Poorest of the poor in the State. And the Plan is free for this group, as the cost is covered under Basic Health Care Provision Fund (BHCPF). EDHIC enroll residents on this plan using the social register.

The online registration portal is embedded in the website. Simply click enroll on the menu and login to www.edhic.org

Children above 18 years are to enroll under the individual plans

The Health plan is determined based on the average income the potential enrollee earn.

sure, here are some of our Accredited Health Facilities on the scheme;

  1. St. Philomena Hospital  | 23, Dawson Road, Off Akpakpava Road, Benin City (Oredo LGA) .

 2. Standard Kings Care Specialist Hospital and Maternity | 10, Ehigie Street, Off Upper Sakponba Road, Benin City  (Ikpoba Okha LGA).

3. St Augustine Medical centre and maternity  | 31, Uwasota street Ugbowo, Benin City (Egor LGA).

4. The Hills Medical Center  | 98, Godwin Abbe Way, Oka, Benin City (Oredo LGA).

5. Igbinedion University Teaching Hospital  | 122, Sapele Road, Benin City (Oredo LGA).

6. Mega Care  | 50, Uwa Street, Off Mobile Crescent, Ogida Barack, Benin City (Egor LGA).

7. Time Hospital  | 2, 3rd Agbonma Lane Off Agbonma Street, Ekewan Road, Benin City (Oredo LGA).

8. Irele Ifijeh Hospital  | Plot  22, Lucky Igbinedion Way, Ikpoba Hill, Benin, City (Ikpoba Okha LGA).

9. Berta Medical Center  | 191, Upper Mission Extension Road, Aduwawa, Benin City (Ikpoba Okha LGA).

10. Ehiabhi Odiase Medical Center | 41, Adolor Street,  Off MM Way Benin City (Oredo LGA).

11. Bamby Hospital  | 28, Obanoza Street/147 Siluko Road, Benin City (Egor LGA).

12. Niger Clinic  | 1, Ogbemudia Street, Behind Maria Filling Station, Benin City (Ikpoba Okha LGA).

13. Tona Medical Center  |  2, Ighodaro Street, Off Benin Agbor Road, Benin City (Ikpoba Okha LGA).

14. Narrow Way Clinic  |  9 Sunday Ahanor Street, Off Effionayi Street, Aduwawa Benin City (Ikpoba Okha LGA).

15. Echos Hospital  |  5, Benin Technical College  Road, Benin City (Egor LGA).

16. Bethel Faith Hospital  |  Plot 11&12 Jbs Layout, Erediawa Street, Off Ekewan Road, Benin City (Oredo LGA).

17. City of Hope Medical Center   |  Km 7 Benin-Sapele Express Road, Benin City(Oredo LGA).

18. Modic Medical Centre   7 Ugiayugbo Street, Off Akenzua Street, Benin City (Oredo LGA).

19. Mount Gilead Hospital   1, Mount Gilead Close, Off Uselu Road, Benin City (Egor LGA).

20. Edi Int. Hospital   1, Coronation Drive, Off Aideyan Avenue, Off Airport Road, Benin City (Oredo LGA).

21. Benin Medical Care  |  53, Adesuwa Grammar School Road, GRA, Benin City (Oredo LGA).

22. Edo Specialist Hospital  | Plot 2, Sapele Road, Benin City (Oredo LGA).

23. Central Hospital  | Sapele Road, Benin City (Oredo LGA)

24. University of Benin Teaching Hospital  | PMB 1111, Ugbowo Lagos Road, Benin City (Egor LGA).

25. Gods Victory and Maternity  | 14, Obayuwana Street, Off Siluko Road Benin City (Egor LGA).

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