Zambia’s National Health Insurance Management Authority NHIMA […]

Zambia’s National Health Insurance Management Authority NHIMA policy meant to protect vulnerable senior citizens is now coming under scrutiny, with concerns emerging that some financially stable elderly citizens are taking advantage of free healthcare coverage at the expense of the system’s sustainability.

A medical care expert who refused to be named has raised alarm over what he describes as growing exploitation of NHIMA’s exemption policy by senior citizens who are accessing full healthcare benefits without contributing financially, despite having the means to do so.

 Speaking in an exclusive interview with Zambian Business Times— ZBT, the expert said the blanket exemption for citizens aged 65 years and above, though socially well-intentioned, is creating financial strain on the national insurance scheme. Under current NHIMA regulations, senior citizens are not required to pay monthly contributions but remain fully eligible for healthcare services at accredited facilities.

The source argued that while the policy was designed to protect vulnerable elderly citizens, it is also benefiting wealthy retirees, landlords, and financially secure pensioners who continue accessing free healthcare despite being capable of contributing.

 “It is not every person above 65 who is poor or unable to pay. We have wealthy retirees, landlords, and financially stable senior citizens who are benefiting from free healthcare simply because the policy allows it,” the expert said.

According to the source, this unrestricted access is placing unnecessary pressure on NHIMA’s funding pool, increasing healthcare claims without generating additional revenue.

 The expert warned that such loopholes are weakening the scheme’s sustainability and contributing to broader financial challenges, including delayed reimbursements to healthcare providers. “The issue is not about denying vulnerable senior citizens healthcare but ensuring that those who can afford to contribute do so fairly so the system remains sustainable,” he said.

Article by Karen Ngulube