NSSF WESTADI Scheme is now launched.

After a successful launch of the Welfare Scheme for Tanzanians in the Diaspora (WESTADI) by His Excellency, President of the United Republic of Tanzania, Honorable Jakaya Mrisho Kikwete in Dulles Virginia USA Last September 2011; NSSF is delighted to announce that, the scheme is now operational.

Welfare Scheme for Tanzanian Diaspora
Welfare Scheme for Tanzanian Diaspora (WESTADI) “The Diaspora all over the world is desperate for a cost effective, customized and reliable scheme that will bring immediate solutions to the arising endless challenges”. NSSF has now ventured into extending its services to Tanzanians living abroad through special Diaspora coverage scheme  called WESTADI

WESTADI

Aimed to cover all Tanzanians living  abroad ( Including Students ) 4 dependants selected by the insured person for Social Health Insurance Benefits (SHIB)  in Tanzania

Premium

Payment of prescribed premium of USD 300 per person per annum


Benefits Package

The main objective of provision of health services is to reduce a burden to Diaspora members of sending more money to cater for health expenses to their relatives back home

Health Services

• Health services will cover insured person while in Tanzania and their four dependants left at home.
• Health Services will include both outpatient and inpatient medical services and it will provide 100% coverage.
• The Fund will accredit medical providers with payment modalities of capitation method for left home families, and fee per visit for the Insured person while in Tanzania.

Repatriation Services

• The main objective of provision of Repatriation services is to curb the high demand for costs coverage to send human remains back home (Tanzania)
• The services will cover the Insured person in Human remains
• The services will cover the cost of human remains and one accompanied person to Tanzania
• The average costs for repatriation shall be subject to ascribed maximum and not dependent of the specific country.

Burial Services

• The scheme will cover costs of burying deceased insured person who opted to be buried in respective Diaspora country
• The costs to be covered will be subject to ascribed maximum and not dependent of the specific country.

Qualifying condition

The insured person has to be current on premium remittance

Registration

Registration is done online through NSSF Website under WESTADI Link

Premium Remittance

Remittance is done online under specific links of remittance platforms such as PayPal.

SERVICE REQUIREMENTS

Health Insurance services

• A dependents to choose a hospital that are within the Accredited hospitals in their respective Regions and the service to begin  immediately after the confirmation of premium remittance by the Insured Person
• Dependents to visit a nearby NSSF office across the country for Health Service subscription process
• The service will stop once the Insured person ceases to remit premium

Repatriation Services

• The next of keen to notify by lodging Death claim online through WESTADI link on NSSF WEBSITE
• The next of keen to provide information of burial services once an insured person opts to be buried abroad (respective Diaspora country)

For any further queries kindly contact:

Rehema H Chuma

General Line: +255 22 2163400-19 Ext 1033

Cellular:             +255 756 140270      

http://www.nssf.or.tz/

Email adress: rchuma@nssf.or.tz

WESTADI FAQ

1. What is the coverage for the Social Health benefit for WESTADI Insured members`  

    dependants?

• Health benefit for WESTADI beneficiaries covers any four dependants (living in Tanzania) selected by WESTADI member.
• Health services will be covered under Social Health Insurance Benefits (SHIB) in Tanzania.

2. What is the health benefit services covered?

• SHIB covers both out-patient and in-patient health services  as  summarized below

Outpatient Services

• Consultation with clinical/medical officer, specialist or consultant
• Basic and specialized investigations
• Minor surgical procedures
• Dispensing of medicines in the National Essential Medicine list
• Referral to higher levels and special hospitals

In-Patient services

• Accommodation (excluding meals)
• Consultation with clinical/medical officer, specialist or consultant
• Basic and specialized investigations
• Minor and major surgeries
• Dispensing of medicine in the National essential medicine list
• Dispensing medicines on discharge
• Referral to higher levels and special hospitals.

3. Are there any limits or exclusions in the health package?

Yes, Social Health Insurance Benefit has limitations and exclusions as follows:

Exclusions:

• Diseases or services covered under Maternity Benefits
• Free services/treatment provided by the Government such as immunization, Tuberculosis and Leprosy, Cancer, HIV/AIDS, epidemics, Mental illness, Diabetic Mellitus.
• Injuries where a third party is involved such as road accident where the vehicle is covered by insurance.
• Cosmetics and cosmetics surgery.
• Services/treatment for self inflicted diseases/injuries like alcohol, drug and tobacco abuse, attempted suicide and criminal abortion.
• Physiotherapy services at home.
• Psychiatric diseases, except during acute illness within 7 days of care.
• Medical examination for employment, schooling and travel purposes.
• Treatment due to diseases/condition arising from participating in an experimental study.
• Therapeutic trials.
• Expensive specialized investigation procedures like MRI and DNA Typing.
• Services/treatment for injuries/conditions arising from active participation in riots, demonstration, unrest and civil strife.

Limitations:

• Emergency services for mobile members (Traveling outside their place of residence);
• Outpatient – not more than 4 times/year and
• Inpatient (48 hours) – not more than 2 times a year
• Hospitalization for a maximum period of 42 days of Inpatient care for 4 dependants per year

4. Does NSSF have its own Health Facilities? If No, which Health Facilities participate in the 

    Scheme?

NSSF does not have its own Health Facilities the scheme has accredited health Facilities to provide medical services to the beneficiaries. These will include Public, Private, Religious and where necessary Employers’ health facilities are accredited. Accreditation incorporate health facilities of different levels including:-

Dispensaries

• Health Centres
• Hospital level I – district and other hospital
• Hospital level II – regional and other hospitals
• Hospital level III – referral and special hospital

5. Is there a cap amount for Health Benefit?

NSSF Social Health Insurance benefit applies a Capitation mode of payment or Fee per visit system for referral hospitals accredited by the Fund. The capitation system operates under insurance principles and therefore beneficiaries are not obliged to pay for their treatment except for services not covered in the benefit package.

6. When will a WESTADI beneficiary start/cease to enjoy health benefits?

WESTADI health services starts immediately after confirmation of premium remittance by the insured person.

However, health services for WESTADI beneficiary will stop once the insured WESTADI member's membership expires and he/she ceases to remit premium.

7. What is the process for beneficiary enrolment for health insurance benefit?

• Dependants will have to go to the nearest NSSF office for enrolment.
• At NSSF they will need to fill WESTADI dependant enrolment form in triplicate, together with the following documents:-
• Three passport size photos
• PIN number they have received from the Insured WESTADI member.
• Photostat copies for IDs of either the following documents: - Tanzania Voter’s card, Bank card, employee card, birth certificate, etc.
• Dependant will have to choose a health facility of his/her preference from a list of SHIB accredited health facilities present in NSSF office.
• Once the above is completed, NSSF will inform the dependant the time for commencement of health services.
• Dependant will have to re-enroll him/herself any period a premium is renewed.

8. Can the beneficiary change hospitals/dependants after enrolment?

• Yes, member can change any active dependant as in the WESTADI Guidelines.
• Yes, Dependant can change Medical Provider as per provided SHIB Guidelines.
• Member changing a dependant has to follow WESTADI guidelines.

Source: National Social Security Fund (NSSF) website