Why Lagos health insurance scheme take-off has delayed  

Emmanuella Zamba, acting General Manager of the Lagos State Health Management Agency (LSHMA) has explained reasons why the Lagos State Health Insurance experienced delayed takeoff after it was launched in 2018.

Zamba told BusinessDay that the need to capture the bio-data of would-be beneficiaries, generate policy identification for every enrollee, among other factors, combined to slow down the takeoff of the scheme, especially for the public sector.

Her explanations came as some teachers in Education District 5, comprising Ojo, Amuwo-Odofin, Ifelodu-Ajeromi and Badagry; in the employ of the state government complain they have been unable to access healthcare services provided via the scheme despite deductions from their salaries.

According to the teachers, the state government commenced deductions from their salaries into the scheme in November 2019. But till date, they have been unable to access healthcare through the scheme in any registered health facilities due to the absence of means of identification.

One of them, who teaches at Navy Secondary School, owned by the Lagos State government, on Old Ojo Road, lamented an out-of-pocket expense of N60,000 last week for the treatment of his wife and first son, who became ill at the same time.

But Zamba disputed the teachers’ claims, saying the state government only recently commenced the scheme for civil servants in June 2020 while the premium payment started in May 2020.

She advanced her position with a circular issued on May 15, 2020 and signed by the state Head of Service, Hakeem Muri-Okunola, which read: “Further to the Head of Service Circular Ref. No.: CIR/HOS/’18/VOL.1/096 of 12th December, 2018 on deduction of premium for the Lagos State Health Scheme (LSHS), it is  hereby notified for general information that the monthly installments of the 25% premium/annum deductible from staff salaries will commence with effect from May, 2020, while public servants and their dependants can access healthcare from their chosen hospitals with effect from 1st June 2020.

Under the scheme, the state pays 75% of the annual premium while the balance of 25% is deducted from the enrollee civil servants to provide healthcare for a maximum of six family members.

The LSHS was launched in December 2018 under the administration of Akinwunmi Ambode with the objective of facilitating easy access to quality healthcare hospitals without having to pay from their pockets.

Zamba said with the full takeoff of the scheme, the workforce is sure of access to quality and affordable healthcare. According to her, public servants would have access to medical care in any of their facility of their choice from the list of 200 public and private hospitals registered under the scheme and spread across the state.

The health scheme would further ensure that the workforce is physically, mentally and psychologically fit to discharge their duties effectively and efficiently.

Commending Governor Babajide Sanwo-Olu for the approval and payment of 75 percent of the annual family insurance premium for each public servant, the balance of 25 percent, according to her, will be paid by public servants over a period of 12 months.

She said that with the payment, public servants in the state as well as their spouses and maximum of four children below 18 years old, have access to enjoy the benefits of the state health scheme.

Under the scheme any additional family member aside from the six mentioned above who is below 18 years old would pay N6,000 annually while those who are 18 years old and above, would pay N8, 500 annually, stressing that “any additional cost would be borne by the public servant, who is the principal enrollee”.

She explained that enrollees on the scheme would enjoy benefits which include enrollment and consultation, treatment of common ailments such as malaria, hypertension, diabetes, family planning services, dental care, ultrasound scan, radiological investigations, child welfare services, care of childhood illnesses, neonatal services, gynecological prenatal care and delivery.