Neftaly Health Insurance Models

Innovative, Inclusive, and Impact-Driven

At Neftaly, we believe that effective health insurance is key to achieving Universal Health Coverage (UHC). Our Health Insurance Models are designed to protect individuals and families from the financial burden of illness while promoting access to quality healthcare across all social and economic groups.

We offer scalable, adaptable, and community-centered insurance models tailored to the unique needs of low-income populations, informal workers, and underserved communities.

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Our Mission

To deliver equitable, affordable, and sustainable health insurance solutions that ensure everyone can access the care they need — without risking their financial security.

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Neftaly’s Core Health Insurance Models

1. Community-Based Health Insurance (CBHI)

• What it is: A voluntary, non-profit insurance scheme run and owned by the community.
• Who it serves: Informal sector workers, rural communities, and low-income households.
• How it works: Members pay small, regular contributions pooled together to cover healthcare costs.
• Benefits:
  • Builds trust and ownership
  • Encourages community solidarity
  • Covers basic health services, referrals, and medicines

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2. Social Health Insurance (SHI)

• What it is: A mandatory insurance model funded by contributions from employers, employees, and government.
• Who it serves: Formal sector employees and public servants.
• How it works: Contributions are pooled into a national or regional health fund to pay for healthcare services.
• Benefits:
  • Broad risk pooling
  • Sustainable long-term funding
  • Strengthens national health systems

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3. Private Health Insurance (PHI) – Neftaly Access Plan

• What it is: A flexible and affordable private insurance plan for individuals, families, and small businesses.
• Who it serves: Middle-income earners, gig workers, and entrepreneurs.
• How it works: Clients pay monthly or annual premiums based on their chosen coverage level.
• Benefits:
  • Choice of providers
  • Access to specialized care and private facilities
  • Digital claims and customer support

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4. Publicly Subsidized Insurance – NeftalyCare

• What it is: A government-supported program where premiums are partially or fully subsidized for the poor and vulnerable.
• Who it serves: Children, elderly, pregnant women, and people with disabilities.
• How it works: Funded through government budgets and external donors.
• Benefits:
  • Full or partial premium coverage
  • Removes financial barriers to healthcare
  • Targets equity and social protection

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Key Features of Neftaly Insurance Models

• Affordable Premiums: Designed for all income levels, especially the underserved.
• Digital Enrollment: Easy sign-up and mobile-friendly systems.
• Cashless Care: Members receive treatment without out-of-pocket payments at partner facilities.
• Portable Coverage: Insurance follows the member across regions and health providers.
• Health Education: Members receive ongoing health promotion and preventive care tips.

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Partnerships & Integration

Neftaly works in collaboration with:

• Governments to align with national health financing strategies
• Private sector to improve service delivery and innovation
• Communities to promote awareness and enrollment
• NGOs & donors to subsidize and scale coverage

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Our Impact

• ???? Increased health service utilization by 60% in covered regions
• ???? Reduced out-of-pocket spending for enrolled families by 70%
• ???? Expanded provider network with over 2,000 partnering clinics and hospitals
• ???? Enrolled over 1 million individuals through community and employer-based schemes

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Join the Movement

Neftaly is redefining how health insurance works — with people, not profit, at the center. Whether you’re an employer, policymaker, donor, or community leader, we invite you to be part of the change.

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