THE EDITOR, Sir:
I REFER to your Insurance Helpline column of Wednesday, June 22, 2005, on the case of the young diabetic and her health insurance.
Firstly, we at the NHF extend our sympathy to the parents who wrote to your columnist regarding their two-year-old daughter who has diabetes. Unfortunately this is not an unusual occurrence in our population today but we also congratulate the parents for having had their child diagnosed and now treating and managing the condition.
Too many persons in our society have chronic illnesses but are not aware of their condition as they do not make regular visits to a doctor to check on their health status. Current estimates are that 75 per cent of persons with chronic illnesses such as diabetes are not treating their condition and 40 per cent do not know they have the illness.
The NHF is established to reduce the burden on our national health care system and the most significant contributor to this burden is chronic illnesses such as diabetes. In addition to diabetes the NHF also provides coverage for asthma, arthritis, breast cancer, epilepsy, glaucoma, high cholesterol, hypertension, ischemic heart disease, major depression, prostate cancer, psychosis, rheumatic heart disease and vascular disease.
Through our Individual benefits programmes, we directly assist persons who are treating these chronic conditions by helping them to obtain the medication necessary.
All residents of Jamaica irrespective of age, gender and income, who are living with these 15 specified conditions, qualify for the NHF card. The NHF card provides a direct subsidy that helps patients meet the cost of purchases at the pharmacy. The subsidy offered for each drug is detailed in the NHF Individual Benefits booklet and is the same wherever the drug is purchased. The NHF subsidy is first applied and the patient is required to make a co-payment of the remainder. This co-payment as pointed out in the column will vary, depending on the brand and the cost at which the participating pharmacy is selling the drug. There are over 800 prescription items on the NHF Individual Benefit Drug List including brand name drugs and over 220 NHF participating pharmacies island-wide.
FIRST PROVIDER
The NHF is also the first provider when purchasing medication in conjunction with other health insurance. The pharmacist will subtract the subsidy offered by the NHF for the prescription item first before applying the benefit provided by other health insurance cards. In this way prescriptions are even more affordable for persons with other health insurance cards.
NHF is a social insurance and this means that those who qualify for the NHF card do not have to wait before they can begin to enjoy the benefit and they do not pay any premiums. The benefit provided is based on the patient's need.
'K.L of Kingston 7' should therefore immediately apply for a NHF card for their daughter. The enrolment process is easy. A tax registration number (TRN) is required for all applicants including children and a doctor has to certify that she has the specified diseases. The card can either be mailed in or taken into the NHF. Having enrolled at this tender age of two years she will never have to enrol with the NHF again should she be unfortunate to need other NHF benefits later in life.
We would also like to advise that NHF individual benefits also carry a programme especially for seniors. The Jamaica Drug for the Elderly Programme, JADEP, provides certain medications free of cost to persons 60 years of age and older through both private and public pharmacies. These pharmacies may charge patients up to $40 to dispense a month's supply of each medication which is a small contribution towards their operating costs.
Whilst the column focuses on NHF individual benefits I would like to mention the NHF institutional benefits which provide support for illness prevention and health promotion activities. These activities are conducted by the Ministry of Health and various government and non-government agencies to educate and inform the general population on improving and maintaining their health.
Persons may contact the NHF for more information at 1-888-NHFCARE (643-2273), 1-888-GOJADEP and www.nhf.org.jm
Yours sincerely,
R.D Barrett
Chief executive officer
