ENROLLMENT OF CORPS MEMBERS INTO NHIS: All You Need to Know

The National Youth Service Corps (NYSC) journey is not only a rite of passage for Nigerian graduates but also an opportunity for personal and professional growth. One crucial aspect of this journey is understanding the healthcare coverage provided through the National Health Insurance Scheme (NHIS) under the Group Individual Family Health Finance Program (GIFSHIP-n). In this comprehensive guide, we’ll list out the details of healthcare coverage for NYSC corps members, ensuring a seamless and informed experience throughout their service year.

Table of Contents

1. Pre-Orientation Period:

  • From the collection of the call-up letter to reporting to the orientation camp.
  • Covered by fee-for-service to accredited healthcare providers.
  • Corps members’ healthcare was verified by NHIS after claims processing by the HMO.

2. Orientation Camp Period (3 weeks):

  • Corps members are covered by an accredited health care provider (HCP) attached to each orientation camp.
  • The HMO pays a one-month capitation directly to the healthcare facility.
  • The Primary Health Care Facility (HCF) provides ambulance services for emergency referrals.
  • Fee-for-service for secondary and tertiary health services.

3. After Orientation Camp:

  • Corps members provided health services based on the public health facility nearest to the place of primary assignment.
  • Access to NHIS-accredited public or private health facilities.
  • Fee-for-service payment method for secondary and tertiary health services.

4. Terminal Leave Period (3 weeks after passing out):

  • Corps members are covered through the NHIS emergency route.
  • HMOs were notified within 48 hours of processing claims.

5. GIFSHIP-N Benefit Package:

  • Out-patient care, including consumables.
  • Maternity care for one pregnancy.
  • Preventive care, immunization, and family planning education.
  • Consultation with the required specialists for secondary and tertiary care.
  • Dental care, eye examinations, and the provision of low-priced spectacles.
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6. Other Benefits:

  • Surgical procedures and specialist care.
  • Management of obstetrics, gynecological conditions, and pediatric cases.
  • Treatment of opportunistic infections.

7. Referral Process:

  • Authorization codes are required for referrals.
  • Referrals to the nearest NHIS-accredited specialist facility.
  • Denials were communicated to the requesting facility within 24 hours.

8. Complaints/Grievance Redress Mechanism:

  • Forms are available at NYSC local government offices.
  • Complaints are addressed within 24 hours to seven days.
  • Grievances may include stock issues, delayed referral code releases, denials, and service dissatisfaction.

9. Partial and Total Exclusions:

  • NHIS pays 50% for high-technology investigations.
  • Limitations on dialysis sessions and specific medical conditions.
  • Total exclusions for certain scenarios like industrial injuries, natural disasters, and specific medical procedures.

Conclusion:

The GIFSHIP-n healthcare program provides a robust framework for NYSC corps members, ensuring access to a wide range of medical services throughout their service year. With a comprehensive understanding of the coverage details, corps members can navigate the healthcare system confidently, focusing on their personal and professional development during this significant phase of their lives.

As the program evolves, corps members are encouraged to stay updated through official NHIS and NYSC channels for any changes or additional information. The GIFSHIP-n is not just a healthcare program; it’s a supportive companion in the exciting journey of the NYSC experience.

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