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Ethiopia - Apply for Ethiopia Social Health Insurance

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Contents

Introduction

Ethiopia Social Health Insurance Scheme can be defined as a system of advance financing of health expenditure through contributions, premiums,payroll/pension contributions made by employers and employees or taxes paid into a common pool to pay for all or part of health services specified by a policy or plan.

This Contribution is based on member’s level of income and fixed rate of their salary. The Coverage is mandatory for everyone working in the formal sector.

  • To ensure that every Ethiopian has access to good health care services
  • To protect families from the financial hardship of huge medical bills
  • To limit the rise in the cost of health care services
  • To ensure equitable distribution of health care costs among different income groups
  • To maintain high standards of health care delivery services within the Scheme
  • To ensure efficiency in health care services
  • To improve and harness private sector participation in the provision of health care services
  • To ensure equitable distribution of health facilities within the Federal republic of Ethiopia.
  • To ensure appropriate patronage of all levels of health care
  • To ensure the availability of funds to the health sector for improved services.

National Bank of Ethiopia,which regulates financial institutions, also oversee the financial performance of the ESHI agency in Ethiopia.

Eligibility

Citizen of Ethiopia who follow in this category can Access the Social health insurance scheme facilities if they have a national identification Card.

  • The widows are eligible.
  • The Students are eligible.
  • The security organs of Ethiopia are eligible.
  • The Employed persons can also access the Social Health insurance scheme through premium deduction from their Monthly Salary.
  • The Low income groups on all Levels in Ethiopia.
  • It contracts with individuals, companies and government agencies for the provision of care and arranges premiums accordingly.

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Instructions

You must be a citizen of Nigeria either working or not working or student or security personnel or a government official or widow.

  • It is very important that you should apply in personal.
  • Every employer is mandated by the law to register with the ESHIS.
  • Every employer must affiliate itself with an EHIS-accredited Health Maintenance Organization (HMO).
  • The registration of prospective enrollees is the responsibility of the HMOs.

Required Information

  • National Identification Card.
  • Names and date of birth certificate.
  • Proof of citizenship
  • Identity card
  • Physical Address
  • Names of the family Members.
  • Information About your recent Insurance policy.
  • Names and addresses of doctors working on you.
  • Your employment

Procedure

1.Start by filling out an application form for the scheme , you should gather information you will likely need when filling out an application.

  • if you're a new member you can apply immediately.
  • The application process for enrolling in government Social health insurance scheme plan is quite simple, because most of the plans will enroll everybody, regardless of pre-existing conditions and current state of health.

2.Just fill out an enrollment form, which includes personal information like:

  • name,
  • Address,
  • Social security number,
  • Designation of the primary insured and all dependents (including the names, ages, dates of birth and social security numbers for all dependents),
  • Employment information including date of hire,
  • And the type of health insurance coverage you select.
  • You'll probably have to provide information about your prior health insurance coverage,
  • Including the insurance company name and policy number.

3.The completed application goes back to the benefits insurance scheme coordinator, who will process your form, and you're finished and the wait to pick your card.

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Required Documents

  • National Identification Card.
  • Names and date of birth certificate.
  • Proof of citizenship
  • Identity card
  • Physical Address
  • Names of the family Members.
  • Information About your recent Insurance policy.
  • Names and addresses of doctors working on you.
  • Your employment
  • Health insurance plan through your employer,
  • medical examination report .

Fees

The fees required to be enrolled to the scheme Contributions are earnings-related.

For the Public (federal) sector programme,

  • However, the employer may decide to pay the entire contribution.
  • The employer may also undertake extra contributions for additional cover to the benefit package

Validity

  • Valid for period of 3-5 years depending on the circumstances.
  • However if you are holding international health scheme.
  • It can be renewed if you decide to extend your stay in Ethiopia.

Documents to Use

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Sample Documents

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Processing Time

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Office Locations & Contacts

Ministry of health

P.O.BOX 1234 Addisababa, Ethiopia.

00251115517011 519366

Email. moh@telecom.net.et

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Video

Videos explaining the procedure or to fill the applications. 
Attach videos using the following tag <&video type="website">video ID|width|height<&/video&> from external websites.
Please remove the "&" inside the tags during implementation.
Website = allocine, blip, dailymotion, facebook, gametrailers, googlevideo, html5, metacafe, myspace, revver, 
sevenload, viddler, vimeo, youku, youtube
width = 560, height = 340, Video ID = Can be obtained from the URL of webpage where the video is displayed.
e.g In the following url "http://www.youtube.com/watch?v=Y0US7oR_t3M" Video ID is "Y0US7oR_t3M". 
	

Information which might help

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Other uses of the Document/Certificate

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e.g. Birth Certificate can be used as proof of identity.

External Links

http://healthmarketinnovations.org/program/ethiopia-social-health-insurance

http://www.msh.org/blog-tags/ethiopian-health-insurance-agency

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