As the word about M-TIBA goes round the country, one of the myths they’re trying to debunk is the fact that M-TIBA only serves those who live under 5 dollars a day and the shocking 40 per cent of Kenyans who cannot afford to seek treatment from hospitals, with mothers and their young children often having to choose between food or health.
Speaking to Dennis Thuku who works in the marketing department at Carepay Limited, one of the partners that brought about M-TIBA, only 2 out of 5 people are insured and most of these people are in the upper middle class bracket. The lower middle-class families usually go for the national solution, NHIF, but getting these same patients – who live under a dollar a day to buy insurance where they are paying premium – puts a bigger strain on them.
M-TIBA thus comes in as a low cost health insurance which most importantly brings transparency and accountability to all stakeholders involved, from the patient to the government.
Paying for healthcare when they need it
“We’re seeing a rise of registered users not only because of the tangibility and effectiveness of M-TIBA but also because most importantly, a registered M-TIBA client cannot be quantified or assessed for viability as an insurable risk.
With the two medical camps already done in Eldoret and Meru, we’ve seen quite the number of diabetes, blood pressure and cancer patients and to the government and insurance companies, they are seen an insurable risks. This means that in case of a scenario where the loss is too huge that no insurer would want to pay for it, the risk is said to be uninsurable and with the rising cases of cancer in Kenya, most insurance policies wouldn’t cover for it,” says Dennis.
Capping coverage and increasing premiums usually deters patients from receiving and completing treatment.
If you get cancer or any other high risk condition, most of the private insurance companies don’t want to take it up because it’s really expensive. If you’re still under the cover, they may pay for the first course of treatment, then after that they give letters that they can’t pay.
Thus, the elegance of the M-TIBA innovation comes to directly fit to the needs of those who can’t afford such lump sums. The patient is now free from being condemned to a life of paying for healthcare out of pocket often at higher than acceptable costs. It also empowers them to choose the healthcare provider of choice.
How it works
So how does it work? Unlike normal M-PESA, the value stored in an M-TIBA wallet can hold different forms: your own health savings, your health insurance cover or yout free health benefits. For example, a government or donor can provide a mobile voucher for a certain type of medical treatment.
You can use such a voucher in your M-TIBA wallet to pay for treatment at one of the clinics selected for the voucher program and linked to the M-TIBA platform. The clinic bills you by submitting the treatment data through a tablet or a PC.
The treatment data is then checked by medical personnel. If the treatment is approved, your payment request is accepted and the money is transferred to the healthcare provider.
With traditional, paper based insurance or voucher systems, healthcare providers often need to wait for many months until they get paid. But since M-TIBA is integrated with M-PESA, the money now arrives at the facility almost instantaneously after the treatment has been approved.
With Safaricom’s unparalleled reach of over 29.5 million customers all across the country, PharmAccess’ experience as a healthcare innovator and CarePay’s revolutionary transaction platform connecting donors, insurers, healthcare providers and patients, it’s the hope of M-Tiba that all these benefits can in future become available to thousands of healthcare providers and millions of people across Kenya.