Q1. What is the difference between the HMO system and the retainership or pay – out – of – your pocket system
ANS. The major difference is in the way medical services are paid for, and delivered to you.
Q2. What is the IHMS Health Plan?
ANS. The IHMS Health Plan is a healthcare program developed by International Health Management Services Limited (IHMS).
The Health Plan is based on the Managed Care Concept - The most advanced and effective method of financing and delivering medical services. Under the IHMS Health Plan, you or your employer or sponsor pay relatively small sums of money into a pool. This money is used to make arrangements with the most appropriate and qualified professionals to provide medical services in case you, your dependants or employees fall ill.
In addition you also enjoy preventive and health promotion services that will not only keep you fit, strong and happy but will reduce unnecessary visits to the hospital.
Q3. How do I Know which health plan to choose?
ANS. If you belong to a company or group, it is likely that your employer or group will choose the health plan for you. If you are buying as a family or an individual, you can choose any plan depending on your need and pocket. Our client and member services officer are equally available to help you make an appropriate choice.
Q4. How many members of my family are covered by my health plan?
ANS. If you joined as a company or group, the company policy determines this but the family plan usually covers you, your spouse and four biological children under 18 years of age. However, extra dependants can be covered by payment of additional contribution.
Q5 . If I am single, can my relations benefit from my contributions?
ANS. No.
Q6: How do you monitor the activities of the hospitals on the scheme?
ANS: Our In-House teams of Care Coordinators who are medical practitioners (Doctors, Nurses Etc) pay scheduled and unscheduled visits to hospitals to ensure standardized and quality treatment.
Q7: How do you guard against under treatment?
ANS: We have entered into formal agreements with every hospital on our network. This contract clearly spells out the standards of treatment that is acceptable to us. Our care coordinators perform oversight functions to ensure that these standards are maintained.
Q8: How do you ensure that only hospitals of high standards are on your network?
ANS: A rigorous selection process is usually adopted. This involves a review of the credentials and certification of participating providers and inspection of their facilities
Q9: Can I choose other hospitals apart from those on your network?
ANS: No. But if you want any provider included in our net work, Ask the provider to apply and we shall carry out an accreditation exercise and if successful, the provider will be included in our network.
Q10.: Can I register with more than one provider?
ANS: No.
Q11 : How often can I visit the hospital?
ANS: As often as you need medical care.
Q12 : Can I collect drugs for my relatives who are not on the scheme?
ANS: No. Treatment is limited to registered members on the scheme.
Q13: what happens if I am not satisfied with the quality of care from a particular hospital?
ANS: Formally complain to our customer care unit. Make sure that you complete our customer complaints form and we shall investigate the case and make appropriate corrections if necessary.
Q15: What happens if I fall ill while outside my locality and can’t reach my primary care provider, or get involved in an accident and none of your hospitals is near by?
ANS: If you are outside your locality, we advice that you seek out an IHMS provider in that locality and obtain care. in the event of an emergency, you may access care from the closest hospital to you, but we advice you get in touch with us within 24-48 hours for us to coordinate your care properly.
Q16: What happens if I misplace my ID card especially when I need to visit the doctor?
ANS: Notify us promptly and apply for a replacement.
Q17: If I have more than four children, or more than one wife can I register them all?
ANS: This depends on the policy of your organization but you can always buyYes, by an extra dependant plan for the other children .
Q18: As a corporate organization, can we replace or substitute our members as the scheme progresses?
ANS: Yes. But note that such membership will be prorated.
Q19: What happens if I attain my medical limit before the year runs out?
ANS: Although the possibility of this happening is very remote, but in such an event , you or your sponsor will be be required to pay for the subsequent treatment or renew your plan.
Q20: Are your premiums paid monthly or annually?
ANS: Premiums are paid annually.
Q21: If I do not exhaust my maximum benefit limits in a year, will I get a refund?
ANS: No. But you may get some incentives.
In case of a medical emergency go to the emergency room of the hospital nearest to you. You should call your primary care physician (PCP) when you have a health problem. If you cannot reach your PCP and have questions about your health, an illness or an urgent medical condition, IHMS Help is available to help you make a decision concerning the most appropriate level of care.
IHMS Help Health Care Advice lines are open 24 hours a day - 07027704548
IHMS Customer Care – 07028646362, 07028646363
When writing to the IHMS Health Plan, always include your Member Identification Number.
Please address all correspondence to
IHMS Customer Care
2, Joseph Street, Off Broad Street, Lagos Island, Lagos,
Nigeria
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