…Ilera eko becomes primary plan, private becomes complementary
All private health maintenance organisations (HMOs) in Lagos State have been mandated to enroll their clients on the State Social Health Insurance Scheme, ILERA EKO by July 14, 2023.
The Lagos State Health Management Agency (LSHMA) made the mandate.
The move comes as the state government kicks off the implementation of the National Health Insurance Act (NHIA) 2022 which demands that all Nigerians get a mandatory social health insurance scheme, regardless of their existing plans.
This means that anyone currently using a private HMO plan will have it replaced by ILERA EKO as their primary insurance scheme, while their private plans then function complementary services.
Emmanuella Zamba, LSHMA general manager in an official statement obtained by BusinessDay said the submission of the details of current enrollees of HMOs to the agency is necessary to generate a unique identification under the ILERA EKO policy.
All existing HMO clients are expected to be enrolled on the ILERA EKO health plan at the expiration of their current health insurance policies.
“The Agency has taken due cognizance of the views and demands of the HMOs as regards ensuring a seamless domestication of the NHIA Act and more importantly, necessary support for HMO businesses to thrive In Lagos State. In furtherance to the above, and In line with the Executive Order of the Governor on the domestication of the NHIA Act in Lagos state, the Agency is taking these steps,” the statement read.
The development implies that the state is going ahead to implement the NHIA act ahead of the unveiling of the official operational guidelines that stakeholders in the health insurance industry are anticipating from the national health insurance authority.
Issues flagged by stakeholders including the lack of cohesion between states schemes and national scheme premiums, poor public awareness of the implication of the act to health coverage and the impact on health insurance companies among others have been left in limbo.
