Health Insurance in Ghana; All About the NHIA

Health Insurance Ghana

Authority’s Mandate
The National Health Insurance Authority (NHIA) was established under the National Health Insurance Act 2003, Act 650, as a body corporate, with perpetual succession, an Official Seal, that may sue and be sued in its own name. As a body corporate, the Authority in the performance of its functions may acquire and hold movable and immovable property and may enter into a contract or any other transaction.

A new law, Act 852 has replaced ACT 650 in october 2012 to consolidate the NHIS, remove administrative bottlenecks,introduce transparency, reduce opportunites for corruption and gaming of the system, and make for more effective governance of the schemes

OBJECT OF THE AUTHORITY
The object of the Authority is to attain universal health insurance coverage in relation to

persons resident in the country
persons not resident in the country but who are on a visit to this country
and to provide access to healthcare services to the persons covered by the Scheme.

FUNCTIONS OF THE AUTHORITY
The object of the Authority is to secure the implementation of a national health insurance policy that ensures access to basic healthcare services to all residents. For the purposes of achieving its object, the Authority may

Implement, operate and manage the National Health Insurance Scheme
Determine in consultation with the Minister contributions that should be made by members of the National Health Insurance Scheme;
Register members of the National Health Insurance Scheme;
Register and supervise private health insurance schemes
Issue identity cards to members of the National Health Insurance Scheme
Ensure
equity in health care coverage
access by the poor to healthcare services
protection of the poor and vulnerable against financial risk
Grant credentials to healthcare providers and facilities that provide healthcare services to members of the National Health Insurance Scheme
Manage the National Health Insurance Fund
Provide a decentralised system to receive and resolve complaints by members of the National Health Insurance Scheme and healthcare providers
Receive, process and pay claims for services rendered by healthcare providers
Undertake public education on health insurance on its own or in collaboration with other bodies
Make proposals to the Minister for the formulation of policies on health insurance
Undertake programmes that further the sustainability of the National Health Insurance Scheme

Develop guidelines, processes and manuals for the effective implementation and management of the National Health Insurance Scheme
Ensure the efficiency and quality of services under the national and private health insurance schemes

Protect the interest of members of private health insurance schemes
Identify and enrol persons exempt from payment of contribution to. National Health Insurance into the National Health Insurance Scheme
Monitor and ensure compliance with this Act and any Regulations, guidelines, policies, processes and manuals made under this Act
Perform any other function conferred on it by this Act or that are ancillary to the object of the Authority.

Vision and Mission Statements
Vision
” To be a model of a sustainable, progressive and equitable social health insurance scheme in Africa and beyond “
Mission
” To provide financial risk protection against the cost of quality basic health care for all residents in Ghana, and to delight our subscribers and stakeholders with an enthusiastic, motivated and empathetic professional staff who share the values of honesty and accountability in partnership with all stakeholders “