PLASCHEMA stands for Plateau State Contributory Healthcare Management Agency. It is an Agency established by the Plateau State Government saddled with the responsibility of managing Health Insurance, thereby ensuring Universal Health Coverage in the State. This means the Agency ensures that every resident of Plateau State has access to timely and quality health care when they need it, without facing financial hardship.

You need health insurance because you do not know when you would fall ill and illness comes at any time including when you don’t have money. With health insurance, you wouldn’t have to pay as much money in the hospital when you are sick. This means you are able to access quality health care in the hospital when you are ill at a cost that is affordable. This mitigates the hardship one goes through in payment for healthcare.

Currently, the Scheme runs four (4) plans: Formal Health Plan, Informal Health Plan, the Plateau State Equity Health Plan and Private Health Plan. (See More link) [The Formal Health Plan is for those who work for government (state or local government) and in the organized private sector. The Informal Health Plan is for artisans and those who are self-employed. The Plateau State Equity Health Plan is funded from 2% consolidated revenue fund of Plateau State and the 17 Local Governments in the State. The Equity Health Plan funds the health care of the vulnerable residents in the State. The vulnerable residents include: People living with disabilities, and the mentally challenged, Orphans and vulnerable children who have been verified by the Ministry of Women Affairs, pregnant women, elderly greater than 65 years of age, children less than 5 years of age, and the Internally Displaced Persons. The Private Health Plan is for those who want to access health services beyond the list of diseases captured in the minimum benefit package of health services

You may have to wait for a maximum of 45 days. This period is to allow for communication between the scheme and the hospital as well as printing your ID cards.

Once you have completed your enrolment processes and your data verified, you are expected to get your ID card within 30-45 days.

A principal enrollee is entitled to a spouse but additional premium is paid to register the additional spouse.

You (as the principal enrollee), a spouse and four biological (or legally adopted) children within the age of 0-18 years.

Yes. Both of you can register. This is because deduction is from both salaries. You are encouraged to register and include other dependents that meet the criteria for inclusion but cannot be accommodated by your spouse.

You can register an additional family member by paying additional premium of ₦12,300 per annum into PLASCHEMA account. The additional member becomes eligible to access health service under the scheme.

If you work for the government or the organized private sector, you can register yourself by obtaining a form from PLASCHEMA, fill the form, attach a passport photograph of your family members whose names appear on the form and duly signed and submit to PLASCHEMA. Your premium will be deducted from source.

You can replace your dependent for any of the following reasons: over-age, death or divorce. The replacing dependent must meet the specified criteria of being a spouse, biological child less than 18 years of age or legally adopted child less than 18 years of age.

Yes. You will still have to register and benefit from the scheme while you are still in service. However, at retirement, the Agency already has your data which qualifies your for automatic migration to the Plateau State Equity Health Plan.

All enrollees are entitled to a Basic Minimum Package of Health Services (BMPHS) which is a comprehensive plan covering a significant number of common ailments in our society. However, if you need additional services, you will pay additional charges as appropriate.

You can access healthcare anywhere in the country. You will need to inform your HMO, health care provider or PLASCHEMA within 48 hours.

You will be registered as an individual after the payment of premium of ₦12,300 into PLASCHEMA account. Your family can also be registered if you pay ₦50,000 per annum. This premium covers a family of six (6) individuals comprising of you (as the principal enrollee), your spouse and 4 biological (or legally adopted) children less than 18 years of age.

No. This is because Health Insurance entails pooling of funds and sharing the risks. This means, there is also a risk that you may use the hospital in the future and contributions from others will be used to pay for your health care.

The dependent will benefit from health services for as long as the premium is still valid only. If the principal is a civil servant and payment is done monthly, the premium expires at the end of the subsequent month. However, if the children become vulnerable by the Agency's poverty index assessment, they can be migrated to the Plateau State Equity Health Plan.

No. Enrolment is done per person and cannot be inherited.

When you enroll into the scheme, you are entitled to a Basic Minimum Package of Health Services (BMPHS). This is a list of health conditions that have been ascertained by stakeholders to be common to citizens of Plateau State. And for which treatment provide immense health benefits to the population.

All residents of Plateau State are eligible to be enrolled into the PLASCHEMA health plan. It is worthy of note that the scheme is mandatory for all residents in the State.

You can inform the Agency or call PLASCHEMA Call Centre on 0700-Plateau (07007528328,) or 0700-PLACARE (07007522273) and you will be informed on what to do. However, you can change your health care provider after 6 months of using the initial one.

Yes. PLASCHEMA is for all Nigerian citizens and legal resident in Plateau State.

No. All health plans are to be rendered in Plateau State, Nigeria.

All enrollees under the scheme are entitled to the Basic Minimum Package of Health Services . However, an enrollee can subscribe to additional services in the private plan.

For the informal sector, the premium is flat at ₦12,300 per annum while for those in the formal sector, the contribution is 5% of basic salary (1.75% by employee and 3.25% by employer). That means it depends on salary for those in the formal sector.

You are not required to pay any fees to change your health care provider.

Yes. You will have to register since deductions are made from source. You should however choose a different health facility and enroll other dependants that were not captured under the NHIA. Additionally, this enrolment provides data for automatic migration to the Plateau State Equity Health Plan upon retirement of the principal.

Yes. Usually, a list of enrollees is sent to the health care provider which can be used to attend to the individual. However, all those with missing cards are expected to process a new card at the Agency at a cost of N3,000 as soon as possible. Replacing your misplaced card is important because it serves as a means of identification in emergency situations where you may have to access care in facilities other than your primary facility.

Yes. You are usually encouraged to choose a health facility close to your house for easy access.

• Willful or intentional engagement in multiple registration.
• Falsification of personal/medical records.
• Willful usage of PLASCHEMA ID cards by unauthorized persons.
• Any other unethical behavior.

• Delete the excess registration
• Notify the employer
• Warning
• Liable to prosecution and pay N100,000 upon conviction
• Correct the records
• Persons involved are liable to prosecution and will pay N300,000 upon conviction
• The enrollee involved should refund the cost of consumed medical care

The HMO is expected to refer you once a diagnosis has been confirmed that warrants such. This should usually be within 24 hours. In the case of an emergency, your healthcare provider can refer you without a referral code and later secure a referral code from the HMO within 48 hours.

Whenever you need healthcare, you are expected to go to the healthcare provider that you chose at the point of enrolment. When your medical condition cannot be managed at that level, you will be referred to a higher-level health facility that has been accredited by PLASCHEMA.

HMO means Health Maintenance Organization.

They are Agents acting on behalf of PLASCHEMA to ensure you have access to quality and affordable healthcare services.

During enrolment, the list of all accredited health facilities will be displayed for you to choose from. Additionally, all PLASCHEMA accredited health facilities have a sticker fully displayed. You can also see the list of all the accredited facilities on the PLASCHEMA website.

Your HMO is assigned to you by PLASCHEMA and it is usually on the list sent to your primary healthcare provider.

No. This is because your MDA or LGA is allocated to a particular HMO. If you have a complaint about any HMO, you can call 0700-Plateau (07007528328).

If you need additional services to the Basic Minimum Package of Health Services, you will need to pay additional fees to secure the additional services.

You can replace your lost PLASCHEMA ID card by doing the following:

1. Come to PLASCHEMA office with a police report signifying the loss of ID card
2. Write to the Director-General of PLASCHEMA for replacement of lost ID card
3. Obtain PLASCHEMA form and fill
4. Pay a token of ₦3,000 into PLASCHEMA account
5. A new ID card will be printed for you

The scheme is mandatory for all residents of Plateau State.

The Tertiary Institution Students Health Insurance Plan (TISHIP) is valid per academic session for all students of tertiary institutions across Plateau state.

Each student is expected to pay ₦4000 for each academic session.

No. 53 Hospital Place, Behind Plateau State Specialist Hospital, Jos Plateau State. Nigeria.

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