DODOMA: THE Minister for Health, Jenista Mhagama, on Tuesday launched the National Health Insurance Fund’s (NHIF) new membership registration system, claims processing system and three new health insurance packages.
Speaking at the launching ceremony, the NHIF’s Director-General, Irene Isaka said the launched registration system enables members to register and self-serve without visiting the fund’s offices.
The system has made it easier for members to sign up.
She said the claims processing system also developed locally has increased efficiency by processing claims quickly using Artificial Intelligence (AI), thus reducing the time taken to make payments to service providers.
Both system were developed by local experts at a cost of 445m/-, which is a significant saving compared to 3.5bn/- that would have cost if foreign experts were involved, she said.
Launched new packages are Serengeti Afya, Ngorongoro Afya and Toto Afya Kadi (TAK) where the first two packages offer varying levels of healthcare services, from general check-ups to specialised treatments. The main difference is in the number of services and the annual cost.
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The Toto Afya package is specifically designed for children and offers two enrollment options: individual and group (through schools). The group enrollment option offers a lower cost and immediate benefits.
Explaining Ms Isaka said Serengeti Afya package offers a wide range of services, from basic to specialised and expert care, with over 1,800 services available.
The annual contribution starts at 660,000 shillings per person. She said Ngorongoro Afya package provides a wide range of basic, specialised and expert services, with over 440 services available. The annual contribution starts at 240,000 shillings per person. The Toto Afya Kadi (TAK) package is for children under the age of 17 who can enroll individually or through their schools, she said.
For individual enrollment, the annual contribution is 150,000/- and there’s a three-month waiting period before benefits can be claimed. For group enrollment through schools, the annual contribution per child is 50,400/-. Group enrollments start immediately and there’s no waiting period.
She said the newly launched packages are supplementary to the basic package, aimed at enabling members to access additional services when needed and giving them the freedom to choose services based on their preferences.
Minister for Health, Jenista Mhagama urged the National Insurance Fund (NHIF) to engage various stakeholders and groups to ensure implementation of the new launched three packages do not lead to complaints from the public.
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She also warned service providers and staff members who misuse the fund for personal gain, especially through fraud and called for the fund’s expenditures to be productive to ensure the sustainability and survival of the fund.
She said the government is aware that the fund is in the process of developing various packages to enable the public to join through the Health Insurance for All Act and urged the NHIF management to ensure that they engage all stakeholders and groups to gather opinions and create packages that would be free of complaints and help stabilise the health sector.
The Minister also commended NHIF efforts to combat fraudulent activities that aim at weakening the fund and contribute to poor provision of health services.
“I also condemn employees who collaborate with service providers to create loopholes for fraud. I want to reiterate that once we identify them, legal action will take its course,” she warned.
Regarding the fund’s expenditure the minister directed for proper management of the fund’s resources and the use of productive expenditures. She urged fund to regularly update its systems, taking into account the actual circumstances and to conduct evaluations and monitoring of members joining the fund and providing the necessary services.
She added that improving the systems will help eliminate the processing of claims, presenting claims, while 80 per cent of the service centres will be connected to control fraud among service providers and beneficiaries.
The Minister also directed the deployment of qualified staff at the fund’s customer service centres to answer sector-specific questions and emphasised the importance of public communication on areas that require clarification, to prevent people from making their own interpretations when correct information is available.
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Moreover, the Minister instructed the management of the fund to implement various directives issued by regulatory authorities, including the Ministry, Parliament, the Controller and Auditor General (CAG), the Bank of Tanzania and Tanzania Insurance Regulatory Authority (TIRA).
The Chairman of the Parliamentary Standing Committee on Health and HIV/ AIDS, Mr Elibariki Kingu said the committee would like to instruct NHIF to control fraud from the grassroots to the national level, invests in digital services, revisits packages and offers costs that meet the needs of both private and government hospitals.
