frequently asked questions

Know your medicines, Ask questions, and always double check

We have provided the answers to a compiled list of questions frequently asked by enrollees and interested parties which will stand as a guide and facilitate a quick understanding of our services. If you can't find an answer for your question(s), just give us a call on any of our lines or fill our inquiry form to let us know.

(Civil Servants/Organized Private Sector). All those who contribute to the scheme as prescribed by the scheme, in addition to a spouse and four(4) biological children below the age of eighteen(18) years.

Each eligible family is allowed a maximum of 6 beneficiaries, as stipulated in (2) above for those in the formal sector programme, but for the informal sector, each contribution covers only one person.

Any member of the family outside the allowable number can be registered as additional dependants.

For those in public service, a total of 2% of gross monthly earnings is deducted towards the running of the scheme. While, it is a fixed amount per participant for those in the informal sector.

Private sector participation is through the employer, who shall share the premium payable for the scheme in such a manner as will from time to time be prescribed by the scheme. A private individual who does not have any formal employment can pay a fixed amount for his/her self and for each family member.

The cards can be collected at BHIS Office and from the BHIS accredited sales agents. Location

No, there will be no rebate.

In social health insurance, there is a cross subsidization where the healthy subsidize for the ill, the young subsidize for the old, and the higher income group subsidizes for the lower income group. This is solidarity, being your brother's keeper.

No, the scheme does not cover overseas treatment.

No, he/she should be enrolled under the Tertiary Institution Social Health Insurance TSHIP. However, if such a child is not yet in tertiary institution, he/she can be covered as an extra dependant.

You can go to the nearest BHIS accredited provider and upon presentation of your ID card, receive treatment. The hospital will contact your primary provider (i.e. the hospital you registered with), who will contact the BHIS Office if necessary.

No, it does not cover all kinds of diseases.
You cannot request for any investigation, specific drugs or procedure, except at the doctor's recommendation/prescription.

No, for now, however the scheme may introduce a co-payment of 10% of the cost of drugs later.

You are required to see your chosen primary healthcare provider first, who will refer you to see a specialist if/when necessary.

The hospital will get an authorization from the BHIS Office and refer you to the most appropriate hospital/specialist (secondary provider) where you will be properly taken care of.

Contact BHIS Office

Report to the BHIS office for clarification.

Yes, if they can be registered as extra dependants

You can contact the BHIS office directly to fill a change of provider form.

No, you are only allowed to use a BHIS accredited provider.

Whenever you experience such mal-treatment, please call the BHIS office and lodge your complaints and we will deal with the situation accordingly.

They are all in the BHIS list which is distributed to the accreditted healthcare providers. Or you can contact the BHIS Office.

You can lodge your complaint to BHIS office in person, call our contact numbers or fill the support form below.

No, It does not cover all kinds of diseases.

Enrolees can access care after 4 weeks for formal sector and 60 days for informal sector enrolees respectively.