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| 1. Who is the Quality Assurance Officer (QAO) in my zone? |
| Answer:- |
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a. Abuja & Northern Operations |
Dr. Jaiyeola - 08023424720
- 07037170677
- 08036446465 |
| b. South East |
Dr. Udegbunan
- 08034706037
-
07071014594
- 08063594678 |
| c. South South |
Dr. John Egbagba - 08039492411
-
08066676660 |
| d. Lagos |
Dr. Olujobi - 08135446932
- 08072128880
- 08084930338
- 08096949814 |
| e. South West |
Mr. S.S. Olorunsuyi - 08028908482
-
08037866956 |
| e. Head Office |
Dr. A. Adebola - 08028255654 |
Contact details
Telephones: Toll free lines.-08031230156, 08031230121
E-mail:p_medicaid@yahoo.co.uk
Our website: www.premiermedicaid.ng.com |
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| 2. How do newly employed staffs of Institutions / Corporations know the modules operandi of their HMO? |
Answer:-
- You may invite Premier Medicaid Staff to come to your office at any venue and time convenient for your establishment.
- The staff may also call the QAO in the zone and arrange to visit the officers in the office of Premier Medicaid.
Enlightenment campaigns are organized from time to time by Premier Medicaid. Please avail yourself to attend when such are advertised.
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| 3. How can we register for the scheme under Corporate Health Insurance? |
| Answer:- Registration can only take place through your Head Office. But for individuals, you can register by following the procedure on the Retail Health Insurance (RHIS) on our website. |
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| 4. How do I choose my provider? |
| Answer:- Look at the provider network on our website, and pick the hospital nearest to your residence. |
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| 5. How do I reclaim money expended /money spent on health? |
| Answer:- You can always reclaim your money if you obtain prior authorization code – the code is issued by the Quality Assurance Officer of your zone. |
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| 6. Why are we not seeing your branded vehicles and ambulances? |
| Answer:- Health Maintenance Organisations ensure transportation through the nearest Health Care Provider and the bill is reimbursed by the HMO. Occasionally, their ambulances can be hired when necessary and paid for by the HMO. |
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| 7. What do I do if my name is not found on the panel list of my chosen provider? |
| Answer:- Call your HMO directly. If your premium is up to date, your HMO will ensure that you obtain your treatment while the problem is being investigated, provided all records are upright and up to date. |
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| 8. My Health Care Provider complains that the HMO has not paid my bill and so wants me to pay ‘out of pocket’. |
| Answer:-Please call your HMO immediately. Your HMO will talk directly to the provider and ensure that you do not pay ‘out of pocket’ depending on the benefit package covered by your premium. |
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| 9. How do I contact my HMO? |
| Answer:- First look at the back of your Enrollee Access Card – the numbers there establish the contacts. Look at our website, the officers are tabulated under the officers of Premier Medicaid. You can also call your Quality Assurance Officer (ref: FAQ 1). |
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10. Enrollees
10.1 I don’t know my Provider/Hospital.
10.2 I lost my enrollee Access Card and I wish to replace it.
10.3 I need a dental/eye service but my Provider does not have in-house.
10.4 My name was wrongly spelt on the enrollee access card.
10.5 I want to report my provider.
10.6 Do I need to sign the claims form before I leave the hospital? YES
10.7 What is the limit to my health benefit?
10.8 If it is emergency and I am rushed to the nearest hospital, who takes care of my bill? |
Answer: Contact your HMO immediately.
Contact details
Telephones: Toll free lines.-08031230156, 08031230121
E-mail:p_medicaid@yahoo.co.uk
Our website: www.premiermedicaid.ng.com
Quality Assurance Officer (QAO) ref: FAQ 1) |
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11. Providers
11.1 We do not have the current panel list.
11.2 Can we use the previous panel list in the current month? NO
11.3 We can’t get the Quality Assurance Officer for authorization code.
11.4 We cannot download panel list sent to us. |
Answer: Contact your HMO immediately.
Contact details
Telephones: Toll free lines.-08031230156, 08031230121
E-mail:p_medicaid@yahoo.co.uk
Our website: www.premiermedicaid.ng.com
Contact Head Office (ref: FAQ 1F) |
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| 12. How can I change my Healthcare Provider? |
| Answer:Send an e-mail to p_medicaid@yahoo.co.uk requesting for a change of provider; state your PIN, and the name of the new hospital. |
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| 12.1. How long will it take for my name to reflect in my new hospital? |
| Answer: it will reflect on the first day of the following month. |
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| 12. 2. If the change has to do with transfer from one location to the other, how would I access medical care. |
| Answer:Call the Quality Assurance Officer of your zone for assistance. The nearest provider to your new location will be recommended. |
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| 12.3. I don’t know the hospital I chose / I can’t remember the hospital I chose. |
| Answer: Send your PIN and name to p_medicaid@yahoo.co.uk, response will be sent back to your e-mail box immediately. |
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| 12.4. How long can my new born baby enjoy the scheme before I register him/her |
| Answer: Neo-natal coverage is 6 weeks, during which the parent must register the child. |
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| 12.5. How do I register my new born baby? |
| Answer: Download the HCC 1 form from Premier Medicaid website, make your payment & follow procedure under Retail Health Insurance. |
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| 12.6. Does my plan cover international treatment? |
| Answer: It depends on the coverage your premium covers, Premier Medicaid, covers international treatment under Diamond Extra. |
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| 12.7. I have registered for some time, but yet to receive my Enrollee Access Card EAC. |
| Answer: Contact your QAOs for assistance, or call 08037866856. |
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| 12.8. Can I go straight to my Ophthalmologist or Dentist without going through my primary Health Care Provider? |
Answer: No, they are specialist and a referral letter is needed to see them.
Contact your QAOs for assistance / clarification. |
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| 12.9. How often can I visit my primary provider? |
| Answer: No limit to visit provided, if it is on medical mission. |
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| 12.10. How many dependants can I register under my name? |
Answer: There is no limit to the number of dependants provided all of them are
paid for individually. |
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| 12.11. What should I do if I go to the hospital of my choice, and I am told that my name is not on their panel list? |
| Answer: Call your QAO for assistance / clarification. |
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12.12. What will happen in case of emergency and I cannot get to my chosen heath care
Provider? |
| Answer: You can go to any nearest hospital in our network of provider and contact your HMO within 24 hrs. |
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12.13. I registered and I have not received my card. |
| Answer: Contact QAO or send e-mail to p_medicaid@yahoo.co.uk. |
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12.14. Can I transfer my card to any of my relatives? |
| Answer: No, insurance is not transferrable. |
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12.15. How can I change my maiden name to my Husband’s name? |
| Answer: Send e-mail to p_medicaid@yahoo.co.uk for such and attach your marriage certificate. |
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12.16. To register for Retail Health Insurance |
| Answer: After you have decided on the plan you wish to enter for, download form from our website and complete it, make payment to our bank account number – GTB 0029558279 and attach the deposit slip to the form and send it to our nearest office. |
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12.17. When you are in an area where there is no health provider under our network. |
| Answer: Call one of the numbers at the back of your access card. |
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12.18. Can I suspend my health insurance plan. |
| Answer: No, you cannot. |
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12.19. What is Tertiary Institution Social Health Insurance Programme (TISHIP) |
| Answer:It is a health insurance plan meant for students especially those in the tertiary institution above the age of 18. |
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12.20. What is Private Health Insurance Scheme (PHIS) |
| Answer: It is a corporate health plan for the organized private sector. The company can choose various benefit packages for different categories of staff i.e silver, gold, platinum, diamond etc. |
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12.21. What is Retail Health Insurance Scheme (RHIS) |
| Answer: It is a health plan designed for individuals who may want to access health care directly without going through corporate organization or employers. |
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12.22. What is Community Based Social Health Insurance Programme? |
| Answer: It is a health plan crafted to suit those in the informal sector who are self employed. The enrolment is directly on household basis which makes it accessible to every citizen through their ward Health Organisations (wHO). The contributions are actuarially determined and made affordable to the community. |
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12.23. I visited my chose primary provider and was not attended to, what could be the
problem? |
| Answer: It may mean that your name was not on the panel list, so call your HMO. |
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