IMPORTANT QUESTIONS AND ANSWER ABOUT HEALTH INSURANCE BILL

IMPORTANT QUESTIONS AND ANSWER ABOUT HEALTH INSURANCE BILL




EXPLANATION OF FREQUENTLY ASKED QUESTIONS BY CITIZENS THROUGH THE MEDIA AND SOCIAL NETWORK ON THE HEALTH INSURANCE BILL FOR ALL.

October 09, 2022 (First Edition)


List of Questions and Answers on the Proposed Legislation of Universal Health Insurance.

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1. Question:

When does the implementation of universal health insurance begin?

Answer:

The Universal Health Insurance Law is expected to be discussed and passed and Parliament in November 2022.

Its draft implementation is expected to officially begin in July 2023 after approval by the President of the United Republic of Tanzania Hon Samia Suluhu Hassan.

2. Question:

Will there be only NHIF or will there be other Funds?

Answer:

Through the proposed Law, the health insurance system in the country you will include Public and Private health insurance.

The proposed law will recognize the NHIF as an Insurance Fund Public Health that will serve Public Servants and citizens others who will choose to join the Fund.

In addition, the Law also allows the existence of private Insurance Schemes Health that will provide Health Insurance services to citizens in formal private and informal sector.

3. Question:

What will be the level of contribution for each citizen and families who are not officially employed?

Answer:

Through the proposed Law, the Minister responsible for health issues through the Code will set contribution rates for taking into account the need for services, actual medical costs and affordability of citizens to contribute and the existing proposals will depend public opinion and the consent of other authorities.

4. Question:

What about citizens who are poor households will be served in order what?

Answer:

Through the proposed Act, people with disabilities will have the right to access medical services through the procedure established by The government after recognizing them through the system of identification of people powerless of the Government.

5. Question:

Will the Member receive medical services anywhere outside the region he lives in?

Answer:

A citizen who joins Health Insurance will have the opportunity to access to medical services at registered service centers and the Fund in any Region

6. Question:

Will there be a limit on the number of dependents in the household?

Answer:

Yes, the proposed Act will limit dependency where A member can register a spouse and a maximum of dependents four as beneficiaries.

7. Question:

Will services for all diseases be provided in the Health Insurance System for all?

Answer:

The benefit package that will be given to citizens will focus on services all available in the treatment guide (STG), National List of

Essential Medicines (NEMLIT) and type of diseases as specified in International Medical Guidelines (ICD 12). In addition, citizens they will get those services from the Dispensary level to the Hospital Nation.

8. Question:

Does a member have the right to move from one Fund to another without any conditions?

Answer:

The proposed law will provide opportunities for some groups citizens choose to join health insurance schemes according to their wishes based on the guidelines set by the schemes health insurance will be available.

9. Question:

What procedure will citizens who are not in the official employment system use?

Answer:

Through the proposed Law, citizens who are not in the system of employees have the opportunity to join health insurance schemes as groups other citizens.

10. Question:

Will there be an Authority to manage these Funds to provide better services?

Answer:

Yes, all Health Insurance Schemes will be administered by the Authority Insurance Administration (TIRA) which will be responsible for ensuring each scheme fulfills criteria and conditions in the provision of quality services for health insurance members. Likewise, members have responsibilities to give information when he is not satisfied with the services provided.

11. Question:

Will the member be allowed to go to the center of any level when he needs access to medical care?

Answer:

To ensure the survival and sustainability of the Fund, during the implementation of Universal Health Insurance Act, beneficiaries of insurance schemes health will be required to follow the referral procedure when accessing services of treatment from the Dispensary level to the National Hospital

12. Question:

What is the Health Insurance Law for All which are not in the country?

Answer:

Despite the fact that the Universal Health Insurance Act aims to ensure access to medical services for local citizens of the country, the Government will continue to coordinate access to services treatment abroad when necessary.

13. Question:

What does Universal Health Insurance mean?

Answer:

Health insurance for all is a program that empowers many citizens to be included in the donation procedure before getting sick and The government to set up a system for citizens who are not able to get medical services without financial constraint.

14. Question:

What is the concept of Universal Health Insurance?

Answer:

Health Insurance is a mechanism to contribute before you get sick.

The concept of health insurance is built on the foundation of solidarity of social in sharing medical expenses among community members and thus afford medical expenses. Illness comes without information, so Health Insurance is a guarantee of treatment

Health Insurance enables the able-bodied and the low-income, patients and non-patients to contribute and get the same services.

15. Question:

Why has the Government decided to enact the Universal Health Insurance Law?

Answer:

The government has decided to enact the Health Insurance Law for All in order to enabling a large group of citizens to access services treatment without financial constraints and thus prevent them from entering epidemic of poverty due to high medical costs.

Thus, the implementation of the Health Insurance Law will facilitate the mission of Government of Better Health for All.

16. Question:

To explain the difference of the National Health Insurance Fund (NHIF), the Fund Community Health (CHF) and Other Funds.

Answer:

The difference between NHIF and a CHF funds and Private insurance companies of health, the size of the scope of registered centers to provide services in the country, the number of services that are in the benefits package as well the absence of service limitation for its beneficiaries.

17. Question:

What are the benefits of the Health Insurance Law if it is passed by Parliament?

Answer:

Some of the major benefits of the Universal Health Insurance Act include:

and:-

i) Avoiding the citizens from the risk of poverty epidemic and high medical expenses;

ii) To facilitate the group of citizens to get medical services without financial constraint

iii) Improving access to medical services in the country,

iv) Having a regulator and manager of the quality of insurance services of health in the country and thus increase the effectiveness of insurance schemes healthy.

18. Question:

What is the concept of linking Health Insurance with other Services?

Answer:

The integration of other services with health insurance has a purpose to encourage citizens to join insurance services Health before illness.

Health insurance will be linked to the following social services:-

• Passport and visa for foreigners

• Motor vehicle insurance

• Taxpayer Identification Number (TIN)

• Telephone lines

• Cooperative membership

• Students enrolling in form 5 and 6 with colleges

• Citizenship ID (NIDA)

However, the implementation of Health Insurance for all will be a step by step. However, groups that will not be required to enter in the first phase of the implementation of the Law will continue get bundled services without the need to have Insurance of Health.

19. Question:

If the Universal Health Insurance Law is not passed, it will have harmful effect?

Answer:

If the Health Insurance Law is not approved by the Parliament, still the group the majority of citizens (85%) will be outside the health insurance system and unable to afford medical expenses and thus being in the risk of poverty or death.

20. Question:

Does this law cover medical services in public and private facilities?

Answer:

Through the proposed Law, all citizens who will join the health insurance will have the opportunity to get medical services in various centers including Government, Private and owned by Religious Sects through insurance schemes health that will join.

21. Question:

If the law is passed, what will be the impact on health services eg access to medicine, services tests?

Answer:

Health Insurance is a sustainable and stable program in the financing of medical services for a large group of citizens.

Thus, through the health insurance system, the centers will have income of certainty and thus be able to improve services treatment including the availability of drugs, tests, medical equipment, etc with human resource

22. Question:

How is the government through the Ministry of Health prepared to ensure services are they better at public stations if the Law is passed?

Answer:

The government has made sufficient preparations in the strategy of Public education, human resources, increasing infrastructure providing urban and rural services, strengthening the Medicines Depot, increase the drug budget and improve treatment guidelines in order to facilitate the implementation of the Health Insurance Law

23. Question:

What challenges have the NHIF and CHF funds gone through in the provision of services?

Answer:

The biggest challenge that NHIF and CHF have gone through is the voluntary nature of citizens to join the Funds, the situation that caused those who joined to be sick.

Voluntary has been harmful to the Funds from serving few members and patients who spend the cost greater than the contributions of the respective members.

24. Question:

What is the experience of Universal Health Insurance for other countries?

Answer:

The process of establishing the Universal Health Insurance Act has gone through various steps including doing research and learning implementation of the Universal Health Insurance Law in the country various countries including Rwanda and Ghana

For the country of Ghana which implements the Health Insurance Act for All has succeeded in increasing the number of citizens in the system of health insurance up to 41 percent of all citizens 2015

The existence of an effective system of registration of members in health insurance system On the part of the country of Rwanda, it has managed to exist in balance (equity) in access to quality health services at all levels all in the country

An increase in the number of citizens who joined the fund from7 percent and reach 90 percent in two years from now in 2017 to December, 2019
Improvement of health services due to delivery centers services have the financial capacity to be returned from the Fund of Community Health.

25. Question:

How will the elderly and pensioners get services under this law?

Answer:

The proposed law has given opportunities to every citizen including pensioners have the right to receive medical services through various health insurance schemes to be registered by the Authority Regulation of Insurance in the country.

26. Question:

What positive results has the NHIF Fund since its inception brought?

Answer:

Since the establishment of the National Health Insurance Fund year 2001, the Fund has made a great contribution to the development of the Sector Health in the country. These achievements include:-

i) Increase the income of health care centers

ii) Enabling a large group of citizens including employees Public access to medical services

iii) Enabling citizens to understand the concept and importance of being and health insurance

iv) Being able to implement the concept of Public Sector participation and Individuals in the provision of health services to citizens

v) To provide experience for other countries to learn in the issues of health insurance

vi) To participate in improving the infrastructure of the provision of medical services in the country.

27. Question:

Specifying the Number of Beneficiaries and members within NHIF,CHF and Private until now?

Answer:
According to the statistics available until June 2022,

The health insurance system has a total of 8,567,486 beneficiaries and 15 percent of Tanzanians

NHIF- 8%

CHF – 6%

SHIB – 0.01%

Private Insurance- 0.09%

28. Question:

Do employers (public and private) have Health Insurance and they will they have to contribute to their employees?

Answer:

Employers will continue with the previous procedure of contributing a percentage six where the employer can contribute three percent or more and employee or servant to contribute the remaining amount.

29. Question:

How is the government planning to control Non Communicable Diseases (NCDs) which is said to have weakened the NHIF Fund?

Answer:

The government continues with the implementation of its programs to combat non-communicable diseases including the delivery of education for citizens on how to avoid these diseases as well as encouraging citizens to exercise regularly and focus on a healthy lifestyle. 

Campaigns for Education continues from the National level and down to in the streets, institutions, schools/colleges and various groups.

30. Question:

How is the NHIF Fund prepared to control fraudulent activities?

Answer:

Combating and controlling fraudulent practices is an issue sustainable, so the Fund has continued with the strengthening of the unit which combats fraud as well as continuity invest in the use of IT systems and provide punishment for those found to commit fraud. In addition, Fraud control unit has been strengthened within the Fund.

31. Question:

Will a citizen who cannot join health insurance be sued?

Answer:

Through the proposed Law, no Citizen who will be prosecuted for failing to join health insurance unless the Government has created an enabling environment for citizens all join.

32. Question:

The proposed Basic Benefit Package will be quality What about the people?

Answer:

The Universal Health Insurance Act has established the right for everyone a citizen who will join any health insurance scheme to get all the services specified in the Benefits Kit of The foundation.

The recommended Basic bonus kit is aimed at enabling all citizens to get services such as seeing him doctor, outpatient services, get tests, get medicine, admission, surgery and maternity services from the level of clinic to National.

33. Question:

What is the meaning of Basic Benefits Kit?

Answer:

The Basic Benefit Package is a bundle of all services important that each patient will qualify according to the standards of the contributions laid down in the Code and according to the Minister
the person responsible for health issues will be improving based on professional advice.

34. Question

Will citizens with private health insurance continue to get it?

Answer:

Citizens with private health insurance according to the Bill of the Universal Health Insurance Law will have the right to continue to get services in those insurances or choose join another insurance.

35. Question

Is a public servant allowed to choose any fund to join?

Answer:

Nope. The public servant will continue to receive services for the current system through the health insurance scheme Public.

36. Question

Will the implementation of this law be immediate for all groups after adoption?

Answer:

No, the implementation of this law will be done step by step action while evaluation is always done before action enter, starting with groups of citizens with official employment (public and private), college students, cooperatives and later groups of citizens without official employment.

These measures aim to ensure that citizens do not miss out linked services, they contribute from their abilities and carried out scientific evaluations before another step.

37. Question:

How dependents are included in the Insurance Bill Who are the beneficiaries of Health for All?

Answer:

Dependents to be included with the member as the beneficiaries are the following:

(a) Parent of member or parent of spouse of member;

(b) A child of a biological, adopted or foster member under the age of twenty one

(c) A blood relative of a member under the age of twenty one years.

38. Question:

Will the member's registration in the health insurance scheme last for what period?

Answer:

Registration of members from the informal sector in the scheme of health insurance will last for a period of one year.

39. Question

How will the poor citizens get social services tied to health insurance as they are unable to pay for health insurance?

Answer:

Incompetent citizens after being recognized by the Government they will be given special identifications that will enable them access to health care and related services without all deadlock.

40. Question:

If the household has contributed and no member of the household has fallen ill period of one year of health insurance membership, is the household will his money be returned?


Answer:

Nope. Health insurance is a mutual contribution mechanism where a household that got sick and spent more than donations provided is contributed by the household that has not had patients.

Thus, citizens continue to be motivated to join that the disease comes without notice.

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