ENROLLMENT OF CORPS MEMBERS INTO NHIS –NYSC GROUP INDIVIDUAL FAMILY HEALTH FINANCE PROGRAMME (GIFSHIP-n) CONT'D

Levels of Care under the Programme

There are three levels of care under this programme:

1. Primary care level
2. Secondary care level(Specialist care)
3. Tertiary care level (Specialist care)

Corps members are assigned HMO based on their state of posting. The HMO assigned at the initial posting remains until the corps member exits from the programme

Referral under the programme

1. Corps members are entitled to secondary and tertiary services.
2. Corps member are also eligible to out of station emergency referral services in any NHIA accredited facility.

Benefit Packages for the Corps Members

The programme shall provide curative, preventive, promotive and rehabilitative healthcare services that are within NHIA’s scope of coverage.

Partial exclusion

However, for high technology investigations and services under the partial exclusion list of the benefit package e.g. renal dialysis, CT scan, MRI: the HMO would pay 50% of cost and NYSC pays the remaining 50%.

Total Exclusions

1. Occupational/industrial injuries to the extent covered under the Workmen Compensation Act.
2. Injuries resulting from Natural disasters, e.g. earthquakes, landslides; Conflicts, social unrest, riots, wars.
3. Epidemics
4. Family planning commodities, including condoms
5. Injuries arising from extreme sports, e.g. car racing, horse racing, polo, mountaineering, boxing, wrestling, etc.
6. Drug abuse/addiction
7. Domiciliary visit
8. Mammoplasty
9. Provision of contact lens.
10. Anti-tuberculosis drugs
11. Treatment of congenital abnormalities requiring advanced surgical procedures e.g. TOF, ASD, VSD.
12. Artificial insemination, including IVF and ICSI
13. Dental Care: Crowns and bridges, Bleaching, Implants
14. Post Mortem examination

NYSC takes responsibility for all the exclusions for the corps members

Corps members are not to pay any money for any services provided

Rights of Corps Members under the programme

1. Right to access 24hrs qualitative healthcare services at the nearest NHIA accredited healthcare facilities.
2. Right to obtain referrals within one hour of request.
3. Right to request full information about treatment.
4. Right to complain to Provider, HMO, NHIA or NYSC

Responsibilities as a corps member under the programme:

1. Have requisite knowledge of the GIFSHIP-n programme
2. Present to NHIS accredited facility when there is need for healthcare services and follow the protocol for service
3. Ensure the HMO liaison person is contacted while in the hospital where he/she is to access care.

Grievance Redressal Mechanisms

1. Complaints on issues relating to service delivery/access, the corps members should contact NHIA (Contacts provided at orientation camps)
2. Use of Complaints/Grievance forms made available by NHIA in all NYSC LGA offices.
3. Corps Members also send their complaints through a text, an email or complete the complaints form in NYSC LGA offices or any NHIA office nearest to them.

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