Question. Can I change my provider at any time I desire?

Answer. Yes. You reserve the right to change hospital any time, if you are not satisfied with the service provided, or when you change location. You will only be required to fill out our change of hospital forms. All requests that we receive before the 15th of the month would be effected by the first day of the subsequent month when the new hospital chosen would have been adequately notified otherwise action may be delayed by a month.

Question. How do I select a Health care provider?

Answer. A list of primary care providers (hospitals) would be provided to you to select one provider. It is advisable to make your choice based on proximity either to place of residence, or place of work or any other personal choice where applicable.

Question. Are the benefit limits transferable?

Answer. No

Question. Can I continue using my old hospital after my enrolment with Melis Medicare HMO?

Answer. Yes. If it is listed on Melis Medicare HMO provider network. But if not listed shall be inspected and listed, provided the hospital meets the minimum required standard and the management of the hospital is willing to join the scheme and abide by the rules guiding our operations. This is in the interest of all enrollee.

Question. Can I change my plan whenever it’s suitable for me?

Answer. Yes.Only at renewal

Question. Do I require any form of identification before obtaining care from the provider?

Answer. Yes. A melis Medicare HMO ID card will be issued to you at commencement of your plan. All you need do to is to present you Melis Medicare HMO ID at the front desk office to see the doctor.

Question. What happens if I should misplace my ID card?

Answer. You will write for a replacement after payment of N500

Question. Can another member of my family use my ID card?

Answer. No. If your plan is a family plan each member of your family will be provided with a Melis Medicare HMO ID card and they are to present it at the front desk office to see the doctor.

Question. Can I choose more than one hospital?

Answer. No. You can choose only one hospital on the scheme but in the case of an emergency, you are allowed to use any hospital on the scheme

Question. Can I choose different hospitals for my family members?

Answer. It is advisable to choose only one hospital for the family, if they are together or specific hospitals for each member of the family if he/she is in different location. However any enrollee can use any hospital on our network of providers in cases of emergency without necessarily being registered there.

Question. What happens to my premium if my family members or I don’t fall ill in the course of the year?

Answer. The premium forms part of the pool of funds from where everybody on the scheme benefits.

Question. Can I use any hospital outside our regular network?

Answer. Use of any hospital in emergency, to save life is encouraged and allowed. You must inform any of the call centers/help lines at once (within 48 hours).

Question. Can I have access to treatment if I fall ill outside my station?

Answer. Yes. Only in emergency situations and this is at the doctor’s discretion.

Question. How many persons can I registered for a family plan?

Answer. Maximum of 6. This will include you (the principal), your spouse and your children/child less than 18 years.

Question. Will I need to make extra payment, for services at provider’s end?

Answer. No. you are not to make any payment for a benefit covered under your plan. Please call Melis Medicare HMO help desk immediately if such arises.

Question. What if my circumstance changes or I need to add other member of my family to health insurance membership?

Answer. You will need to fill a “new inclusion” form. New entrant must be received by the 15th day of the month otherwise action may be delayed by a month.