Frequently Asked Questions

An individual or institution that provides medical services (e.g. a physician, hospital, and laboratory)

A healthcare professional responsible for providing a wide variety of basic healthcare services. This is usually the entry point into the healthcare system. The PCP has an on-going relationship with the individual and knows the patient’s medical history; and therefore is responsible for the coordination of the care of the enrollee.

A person who has enrolled (or have been enrolled) with NHIS and who by being up to date with payment of Premium (or having been paid for) is entitled to cover by NHIS.

This is same as a beneficiary.

The form will be duly processed, which includes the issuance of a policy number and the medical scheme I.D card. Upon issuance of your I.D card you can go to the Primary Care Provider indicated on your form to receive care when the need arises.

Yes, changes can be made under the following circumstances

• - Transfer to another location, city or state
• - Dissatisfaction with quality of care delivered by your chosen provider.
• - Change of enrollee’s place of residence.

Visit the UCHM office or any NHIS office in your location and pick up the change healthcare provider form, fill it and attach a passport and submit.

Only providers accredited for this scheme can be used. You are expected to choose from this list of providers. It is possible your current doctor’s hospital facility might be on our network already, in which case you should be able to choose him/her.

You will be required to formally apply in writing to UCHM for a replacement of I.D. card, supported with a sworn affidavit. Replacement of lost I.D. card will be at a minimal cost to the enrollee.

Organization

• - Better financial void of the setback of medical allowance to staff, retainer hospital and in house clinics.
• - Improve workforce, which leads to high productivity.
• - Prepaid premium makes health care budgeting easy and effective.

Staff

• - Wider choice of health care providers
• - Easy access to quality health care facilities effectively monitored by both NHIS and HMOS
• - There is no restriction of numbers of visit to the choice providers for enrollees.

It is the payment made by the enrollee to the accredited pharmacy provider at the point of service.

Exclusions are conditions that are excluded from the benefits package of the NHIS

Either you or the hospital should immediately contact us to verify your payment. When this is done, you should be able to receive treatment.