The Private Health Insurers Association (PHIA) has pegged its base premium at GH¢1,000 for all minimum plans offered to its members in the country.
The PHIA said the upgrade of the base premium is to enable it to afford the current and escalating healthcare service provider tariffs and also ensure sustainability of its scheme.
President of PHIA, Ronald Oppong Adom, in a release said members of the association at a meeting held on June 17, 2015 resolved that it has become necessary for members to adopt steps in line with premium reviews, focused utilisation management protocols and increased stakeholder engagement to ensure sustainability.
He said the actuarial analysis of healthcare claims cost against premiums showed that private health insurance companies are not sustainable if action is not taken.
“The time has come for a change in perception towards medical care. Healthcare costs money and must be paid for if we are to get value for money,” he said.
Explaining further, he said the drivers of the economy are the human resources and, therefore, the healthcare needs of the members and families cannot be compromised.
“We are responsible for financing the medical care for about 200,000 scheme members. As an industry with a huge potential for growth, we have deemed it necessary to act together to towards protecting the interest of quality and affordable healthcare in spite of the harsh prevailing economic trends,” he added.
Mr Adom disclosed that bearing in mind malaria, pregnancy-related attendances and upper respiratory infections as major drivers of claims cost, the association will effective this month introduce waiting periods and sub-limits for pre-existing conditions and surgeries.
He also indicated that client contracts are to be updated with a utilisation control threshold of 80 percent to provide a window to renegotiate premiums for an entire group once the threshold is reached.
“The concept of co-payment is also being introduced for clients who want to use high cost facilities,” he said.
The president of PHIA assured clients of the association’s commitment to their access to medical care at all times.
By Jamila Akweley Okertchiri