This document provides the benefits package of the National Health Insurance Scheme as offered to its beneficiaries through private health providers.
The Insurance Act of 2021 establishes the National Insurance Commission, and provides for the regulation and supervision of the insurance market and related matters.
This Act provides for sound financing for the national health system; provides for universal access to quality insured health care services; establishes the National Health Insurance Management Authority and provides for its functions and powers; establishes the National Health Insurance Scheme and provides for its systems, procedures and operation; establishes the National Health Insurance Fund and provides for contributions to and payments from the Fund; provides for accreditation criteria and conditions in respect of insured health care services; provides for complaints and appeals processes; provides for the progressive establishment of provincial and district health offices of the Authority; and provides for matters connected with, or incidental to the foregoing.
The National Health Insurance Act was adopted to establish a National Health Insurance Authority to implement a National Health Insurance Scheme, establish a National Health Insurance Fund to pay for the cost of health care services to members of the Scheme, establish private health insurance schemes, and to provide for related matters.
The National Health Insurance Regulations of 2004 govern the registration, management, and oversight of health insurance schemes licensed under the Health Insurance Act of 2003, detailing requirements for licensing conditions, and fees. They mandate non-discrimination, set minimum benefit standards, and outline procedures for interim management and the accreditation of healthcare facilities.