NATIONAL HEALTH FUND PRESENTATION
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1 NATIONAL HEALTH FUND PRESENTATION WYNDHAM KINGSTON HOTEL KINGSTON JULY 28, 2012
2 TOPICS FOR PRESENTATION NHF - HISTORY - BENEFITS - APPLICATION - ENROLMENT JADEP - CONDITIONS COVERED NHFCARD - CONDITIONS COVERED - DIABETES - GLUCOMETERS, HbA1c - ASTHMA - RESPIRATORY DEVICES - COORDINATION OF BENEFITS MEDICATION ADHERENCE SOURCES OF INFORMATION AND ASSISTANCE
3 HISTORY OF THE NATIONAL HEALTH FUND National Health Fund Act 2003 Core functions: Individual Benefits NHFCard enrolment and subsidy availability JADEP system implemented and card production commenced Institutional Benefits Public Information
4 HISTORY OF THE NATIONAL HEALTH FUND National Health Fund and Health Corporation Limited Merger Addendum to National Health Fund Act dated March 9, Additional core functions: Procurement of pharmaceuticals Warehousing Distribution Retail pharmacy operations Drug Serv
5 VISION STATEMENT To reduce the financial burden of healthcare on the public.
6 MISSION To reduce the financial burden of healthcare on the public sector, in Jamaica, by providing funding and information to support improvements in health and to continually improve our processes to better serve our beneficiaries.
7 BENEFITS Three categories: Individual Institutional Public Information
8 INSTITUTIONAL BENEFITS Two categories: Health Promotion and Protection Fund Health Support Fund
9 PUBLIC INFORMATION Through: Community activities Health fairs Advertisements Booklets and brochures
10 INDIVIDUAL BENEFITS Provides assistance through two programmes: - NHFCard - JADEP (Jamaica Drugs for the Elderly Programme) Each providing a benefit card Provider pharmacies islandwide: NHFCard 397 JADEP - 253
11 BENEFICIARY APPLICATION PROCESS Obtain form from: - NHF Offices - Hospitals - Health centres - Doctors offices - Pharmacies Complete form : - JADEP Pink - NHFCARD Yellow TAXPAYER REGISTRATION NUMBER ESSENTIAL FOR NHFCARD APPLICATION.
12 SUBMISSION OF THE BENEFICIARY APPLICATION FORM Mail application form Submit form at NHF: * Head Office 25 Dominica Drive, New Kingston * Help Desk - Mandeville Regional Hospital - Cornwall Regional Hospital - St. Ann s Bay Hospital Turnaround time two (2) weeks.
13 STATUS CHANGE If there is a change in beneficiary s status in: Name Address Health Condition/Illness Complete NHF Change Form (Blue). Submit to NHF for system changes to be effected. No new card issued.
14 USING THE CARD The card can only be used with a valid prescription. At a Provider pharmacy. NHFCard Beneficiary required to pay difference between total cost and subsidy. Card expiration date Even after date passed, card still valid. BENEFIT CARD MUST BE KEPT IN CUSTODY OF BENEFICIARY ONLY.
15 THE ADJUDICATION PROCESS Item prescription drug, diabetic supply, respiratory device MUST be covered by the programme. Check that name on prescription and card correspond.
16 ENROLMENT AS AT MAY 31, 2012 PROGRAMME NUMBER OF BENEFICIARIES GENDER OF BENEFICIARIES MALE FEMALE Number Percent Number Percent Number Percent NHFCARD JADEP 302, ,
17 JAMAICA DRUGS FOR THE ELDERLY PROGRAMME (JADEP)
18 JAMAICA DRUGS FOR THE ELDERLY PROGRAMME Assumed management of Jamaica Drugs for the Elderly Programme (JADEP) in January System implemented and in-house JADEP Health Card production commenced July Provides drugs free of cost for ten (10) chronic illnesses. For Jamaican residents over sixty years. Beneficiary pays $40 per item, to a maximum of $240.
19 CHRONIC ILLNESSES COVERED - JADEP Arthritis Asthma Benign Prostatic Hyperplasia Diabetes Glaucoma High Cholesterol Hypertension Cardiac Conditions Psychiatric Conditions Vascular Conditions
20 NHFCARD
21 NHFCARD Enrolment began April 28, Subsidy became available August NHFCard provides assistance for fifteen (15) chronic illnesses For Jamaican residents. Subsidy provided on: approximately two hundred and fifteen (215) active ingredients, (over one thousand three hundred (1300) prescription pharmaceuticals). diabetic supplies and respiratory devices.
22 CHRONIC ILLNESSES COVERED - NHFCARD Arthritis Asthma Benign Prostatic Hyperplasia Breast Cancer Diabetes Epilepsy Glaucoma High Cholesterol Hypertension Ischemic Heart Disease Major Depression Prostate Cancer Psychosis Rheumatic Heart Disease Vascular Disease
23 DIABETIC SUPPLIES PROGRAMME NHF Beneficiaries, living with and enrolled for diabetes, have access, free of cost to: - Glucometer and - Insulin pen Call NHF customer service department, provide with: - Name - Contact number or address - NHFCard number - Name of item required Beneficiaries allowed one of these items every two years.
24 HbA1c BENEFIT FOR DIABETES Haemoglobin A1ctest (HbA1c): Lab test which shows average blood glucose level over last three months. Is an NHFCard benefit. NHF Beneficiaries, living with and enrolled for diabetes four A1c tests annually. Non-diabetics (NHF Beneficiaries) one A1c test annually.
25 ASTHMA RESPIRATORY DEVICES Respiratory devices - help deliver asthma medication more efficiently to the lungs. Effective January 2011, NHF Beneficiaries, living with and enrolled for asthma (~ 32,000), have access to subsidies for Spacers and Masks. Will be allowed one Spacer every three years and one mask every year.
26 NHF COORDINATION OF BENEFITS
27 NHF COORDINATION OF BENEFITS (NHFCoB) NHFCoB is a mechanism whereby two or more Insurance plans electronically coordinate their respective benefits to maximize the total benefit that the beneficiary receives, thus minimizing their out-of-pocket expenses. Implemented May 2, 2008.
28 ADVANTAGES OF NHFCoB TO BENEFICIARIES One card necessary. Lower out-of-pocket costs.
29 MEDICATION ADHERENCE
30 MEDICATION ADHERENCE BROCHURE
31 SOURCES OF INFORMATION AND ASSISTANCE Books - NHF Individual Benefits FOR PRESCRIPTION DRUGS * - Guidelines For Healthcare Professionals * The National Health Fund Customer Service Charter Brochures - Chronic Illnesses - Medication Adherence * NHFCARE ( ) Facebook Twitter Website - Drop the Salt Protect Your Health* Help Desks - Cornwall Regional Hospital - Mandeville Regional Hospital - St. Ann s Bay Hospital
32
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