The ANCS health mutual is being set up as part of the national Universal Health Coverage programme, which was launched in 2013 by the Senegalese government with the aim of improving affordability and equity of access to healthcare for all Senegalese. Its aim is to provide medical care for ANCS targets, including people affected by HIV and their families, NGO workers in particular and the community in general.
Beneficiaries of health care benefits offered by the mutual insurance company are subject to the following conditions:
The membership fee is 7000 FCFAIt is individual, and each beneficiary must pay his or her contributions in advance in order to receive health care benefits.
The membership fee is annual (12 months) with half-yearly payments.
The membership fee is 15 000 FCFAIt is individual, and each beneficiary must pay his or her contributions in advance in order to benefit from the healthcare services guaranteed by this package.
It is for one (1) month if the subscription is annual and (2) months if it is semi-annual.
-A photocopy of your identity card ;
-Two (2) passport photos.
-A photocopy of the NIC and two (2) passport photos for each spouse;
-A birth certificate and two passport photos for each child under 18.
GUARANTEED MINIMUM CARE PACKAGE (Health centers and hospitals (Mandatory referral for hospital care) | |||
Benefits covered by the mutual health insurance plan | Coverage rates by the health mutual | ||
Outpatient care | |||
- General curative consultations, dental, ophthalmology and other specialists | 80% | ||
- Dressings, injections, transfusions | 80% | ||
- Minor outpatient surgery | 80% | ||
- Ambulatory and dental care | 80% | ||
- Ultrasound | 80% | ||
- X-ray (only in public facilities) /Scanner/Echography | 80% | ||
- Medical analysis/Laboratory | 80% | ||
Medicines Private dispensaries - (capped at 100,000F per year) | 50% | ||
- Generic drugs (IB) | 80% | ||
Transport | |||
- Ambulance | 80% | ||
Hospitalization | |||
- Hospitalization (1 to 7 days) | 80% | ||
- Hospitalization (over 7 days) | 50% | ||
- Ultrasound | 80% | ||
- Medical analysis/Laboratory | 80% | ||
- Generic drugs | 80% | ||
- Medical Consumables | 80% | ||
Maternity ward | |||
- Prenatal consultation | 80% | ||
- Post-natal consultation | 80% | ||
- Planification familiale | 80% | ||
- Simple delivery | 80% | ||
- Hospitalization | 80% | ||
- Ultrasound | 80% | ||
- Medical analysis/Laboratory | 80% | ||
- Generic drugs | 80% | ||
Exclusions : - Eyeglasses - Contact lenses - Prostheses (including dentures) - Orthotics - Treatment outside Senegal - Physiotherapy Parapharmacies - Gels and lubricants - Hypertension products |
SPECIFIC PACKAGE (Health centers, private practices and clinics, hospitals (Compulsory referral for hospital care services) | |||
Benefits covered by the mutual health insurance plan | Coverage rates by the health mutual | ||
Outpatient care | |||
- General curative consultations, dental, ophthalmology and other specialists | 80% | ||
- Dressings, injections, transfusions | 80% | ||
- Minor outpatient surgery | 80% | ||
- Ambulatory and dental care | 80% | ||
- Ultrasound | 80% | ||
- X-rays: CT, MRI and mammography | 80% | ||
- Medical analysis/Laboratory | 80% | ||
- Medical analysis/Private laboratories | 25% | ||
Private pharmacies - (annual ceiling 150000F) | 50% | ||
- Generic drugs (IB) | 80% | ||
Transport | |||
- Ambulance | 80% | ||
Hospitalization | |||
- Hospitalization (1 to 7 days) | 80% | ||
- Hospitalization (over 7 days) | 80% | ||
- Ultrasound | 80% | ||
- Medical analysis/Laboratory | 80% | ||
- Generic drugs | 80% | ||
- Medical Consumables | 80% | ||
Maternity ward | |||
- Prenatal consultation | 80% | ||
- Post-natal consultation | 80% | ||
- Planification familiale | 80% | ||
- Simple delivery | 80% | ||
- Hospitalization | 80% | ||
- Ultrasound | 80% | ||
- Medical analysis/Laboratory | 80% | ||
- Medical analysis/Private laboratories | 25% | ||
- Generic drugs | 80% | ||
- Surgery (ceiling 500,000F) | 80% | ||
- Prostheses (dental ceiling 50,000 F CFA) | 80% | ||
- Eyewear (maximum 50,000 F CFA) | 80% | ||
Exclusions : - Contact lenses - Orthotics - Treatment outside Senegal - Cosmetic surgery - Physiotherapy Parapharmacies - Gels and lubricants |
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