The Tertiary Institutions Social Health Insurance Programme (TISHIP) is a social security system whereby the healthcare of students in tertiary education institutions is paid for from funds created by pooling the contributions of students.
- 2. The Purpose of the programme:
The purpose of TISHIP is to provide adequatehealthcare needs of students in tertiary schoolswho constitute a significant percentage of the country’s population, especially those who have attained the age of 18 years cannot benefit from the public sector programme as dependents of enrollees. TISHIP therefore, is designed to cover this significant section of the population.
1.3. Objectives of the Programme:
- To ensure that every student in tertiary education institutions has access to good health services.
- To protect students from the financial hardships of huge medical bills
- To maintain a high standard of healthcare delivery services within tertiary institutions
- To ensure the availability of funds to the tertiary institution health centres for improved services
- To take cognizance of the peculiar health needs of students in the design of the programme, including access to periodic health education and outreaches
2.0. Stakeholders of the Programme:
2.1. Students Union
- Enlightenment and sensitization of students on the benefits and operational modalities of TISHIP.
- Enlighten the students on the need to pay for TISHIP upon resumption of each academic session.
- Create demand in the institutions’ health facilities by encouraging the students to register at the facilities upon resumption of a new academic session.
2.2. Health Maintenance Organization (HMO)
.Shall participate in the activities of the TISHIP Management Committee (TMC)
- Shall enter into contract with the secondary Health Care Facility for the provision of secondary healthcare services to registered students
- Shall be responsible for the prompt issuance of approvals, as well ensuring properadherence to and completion of procedures for appropriate referral
- Shall be responsible for fee-for-service payments in session for secondary services
- Shall be responsible for fee-for-service payments off-session to accredited facility for primary and secondary care. The HMO will thereafter be reimbursed by the TMC for primary care only.
- Shall conduct periodic enlightenment and sensitization of students on TISHIP, in collaboration with the TMC and the health care facility.
- Shall in collaboration with the health care facility and the TMC be responsible for establishing quality assurance mechanisms for effective health care delivery.
3.0. Operations of the Programme:
Membership is for full and part-time students of Federal, State and Private Tertiary education Institutions who are not on any form of mandatory health insurance.
3.2. Eligibility and Registration:
- Students shall pay contribution to health insurance agencies
- Studentsprovide evidence of payment for health insurance enrollment as part of the annualregistration process.
- The student’s school identity card serves as the ID card for the programme.
- The student must ensure she/he is registered at the institution’s Health Centre/ Clinic.
3.3. Benefit Package
- The Benefits Package is as defined by National Health Insurance Authority (NHIA).
- It consists of promotive, preventive, curative and rehabilitative services at both primary and secondary levels of care.
- All services will be provided using public and private health facilities accredited by the NHIA.
3.4. Provision of Healthcare Services:
- The School Healthcare Facility shall serve as the Primary Healthcare Provider for the programme. Which is the entry point and serves as the gatekeeper.
- In the absence of a healthcare facility within the school or if the school healthcare facility fails to meet NHIA requirement for accreditation of primary healthcare facility,the institution will identify a facility accredited by the NHIA to provide healthcare services to the studentsfollowing authorization by NHIA.
- NHIA accredited Secondary/ TertiaryHealthcare Facilities shall provide secondary care services to students referred by primary healthcare facilitiesfollowing authorization by NHIA.
- In case of emergencies, direct referral without recourse to NHIA/HMOcan be made. However, NHIA/HMO must be notified within 48 hours.
- In case of emergency, students can access care at any NHIA accredited facility upon presentation of the institution’s student identity card and NHIA identity card. However, the School Authority and NHIA/HMO must be notified within 48 hours.
- Students are to access care at the school healthcare facility when school is in session.When the school is not in session, students can access care at any NHIA-accredited facility upon presentation of the institution identity card. The Healthcare Facility shall notify NHIA/HMO within 48 hours. Such services provided shall be paid for through fee-for-service PPM.
- School healthcare facilities shall operate a current bank account with a commercial bank, into which all payments for services provided will be made.
- Funds accruing to the schoolhealth facilities for the programme shall be used only for medicines, treatment commodities, consumables, laboratory reagents, equipment, and other inputs for effective service delivery.
- In the case of forceful closure of any institution, the students of institutions will access care from any nearest NHIA-accredited facility. NHIA/HMO shall reimburse such facilities the cost of the services renderedon fee-for-servicebasis following the submission of evidence of such transactions.Capitation payment made to the school health facility shall be refunded to the NHIA for the period of the closure.
- Students involved in such treatments shall inform the head of the institution’s health facility before or during the treatment and submittheir medicalreport to the School Authority.
- Referrals will be through the three levels of healthcare, with care being rendered at the appropriate level.
- The criteria for referral shall be in accordance with established NHIA principles and procedures, where prescribed skills and services specific to each level are strictly adhered to.
3.6.Grievance and Arbitration:
- Complaints by students are to be addressed by the school’s primary healthcare facility.
- Institution Arbitration Committee: An aggrieved student is expected to first seek redress from the Institution Arbitration Committee comprising of the Dean, Student Affairs, NANS branch chairman, head of the School Health Centre, and representative of NHIA/HMO.
- Unresolved cases should be referred to NHIA/HMO
- Cases that are not resolved by NHIA/HMO shall be referred to the Health Insurance Arbitration Committee.
- Prescribed sanctions will be in line with the NHIA Operational Guidelines.
The beneficiary will be deemed to have exited the programme upon: Completion of the specified course of studies or withdrawal or expulsion from the institution.
ABOUT SONGHAI HEALTH TRUST LTD (HMO)
Is a registered Health Maintenance Organization with the corporate affairs commission in 2001. Accredited and certified by NHIA as a National Health Maintenance Organization from 2005 to date.
‘’To be become the most efficient managed care service provider in Nigeria’’
To provide personalized healthcare experience through cost effective solutions, seamless technology, transparent engagement with all stakeholders.
For enquiry, complaints contact: 08079393233