By Sarah NEGEDU
The Federal Capital Territory Health Insurance Scheme has urged enrollees to immediately call its customer service lines whenever they are denied services at health facilities under the scheme.
This follows the recent payment of over N4 billion in backlog capitation to healthcare providers, approved by the FCT Minister, Nyesom Wike, and disbursed through the Health Maintenance Organizations.
In a statement issued by the Acting Director of FHIS, Dr Salamatu Belgore, said the scheme is now in a stronger position to sanction HMOs and healthcare providers who fail to deliver quality service to enrollees.
She said, “The FCT Health Insurance Scheme, FHIS, is committed to providing quality, equitable and affordable healthcare to all FCT residents irrespective of financial status. We are currently providing health insurance coverage to over 200,000 enrollees in FCT and beyond.”
Dr Belgore warned healthcare providers against service denial, untimely attention, and incomplete service delivery, saying the scheme will act on verified complaints reported in real time.
“It is the position of the FCT Health Insurance Scheme that no enrollee be denied access to healthcare services including consultation, laboratory investigations, drugs as provided for in the benefit package and implore enrollees to call us or visit the FHIS desk in the public facilities immediately that happens.”
“To prevent these attitudes from healthcare providers, the FHIS insists that our enrollees are to place a call to our service lines immediately. They are not required to pay out-of-pocket for any of the services that is covered by the FHIS,” she said.
She added that while a 10 percent co-payment applies to drugs, all other covered services should be fully accessed without additional charges.
Belgore emphasised the need to call while still at the facility to guarantee fast resolution: “We insist you call these numbers while in the hospital so that we have details of the issues on the spot and resolve them immediately. Several times when the enrollees leave the hospital and complain later, some of the facilities deny such encounter. So call us immediately, not after.”
She also disclosed that the scheme’s official website is being upgraded to support self-enrollment, with deployment expected within four weeks.
“Our FCTA secondary health facilities have FHIS desk officers stationed at the facilities that could be visited during official working hours to further assist,” the statement added.
Dr Belgore said efforts to expand coverage are ongoing, with support from the Mandate Secretary of the Health Services and Environment Secretariat, Dr Adedolapo Fasawe.
“As part of efforts to improve the scope of coverage, the Mandate Secretary and the management of HSES has facilitated the review and upgrade of the benefit package and FHIS guidelines for improved services and coverage,” she said.
She noted that capitation to health facilities and HMOs has been revised upward since July 2025 “to reflect the current financial realities.”
The new premium for individual enrollment has also been reviewed to N22,500. “This aligns with the principle of solidarity in health insurance, which means that the more numbers enrolled, the larger the pool and quality of services in line with the Universal Health Coverage, UHC, goals,” Dr Belgore explained.
She reaffirmed the scheme’s commitment to collaboration and feedback from the public: “The FHIS is opened to any dialogue, suggestion and observations coming from our esteemed enrollees as we aim to provide quality and affordable healthcare in the FCT.”
