ENROLEE RIGHTS

  • Right of access to medical treatment as covered by the benefit package under the Scheme.
  • Right to choose a provider of hi/her choice as long as such a provider is accredited by the Scheme.
  • Right to be issued with an NHIS identity card after being registered with the Scheme.
  • Right to change Primary Healthcare Provider after three (3) months of initial access.
  • Right to immediately change his/her provider if the facility is closed, relocated or the employee is on transfer to another town.
  • Right to complain to the HMO about any act of negligence on the part of the Healthcare providers.
  • Right to access medical care for spouse and four (4) biological children.
  • Right to give constructive criticism of the operational methods of the Scheme.
  • Right to be referred for specialised investigations or care. Referral means sending a patient for a range of specialized investigations or care through the recognized three levels of services:
    • Referrals made by primary healthcare provider to the secondary provider.
    • Referrals made by the secondary provider to tertiary provider.
    • Lateral referral from one specialist to another within the same level.