calculate_nhia_copay
Calculate Nigerian National Health Insurance Authority (NHIA) and State/Private HMO split-billing: 10% patient pharmacy co-payment vs 90% HMO coverage on Essential Medicines List items and Fee-For-Service (FFS) pre-authorization in Naira (₦).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| eml_drugs_naira | Yes | Total tariff of NHIA Essential Medicines List (EML) drugs in Naira (₦) eligible for 90% HMO / 10% patient co-payment. | |
| non_covered_naira | No | Total out-of-pocket non-formulary or excluded items in Naira (₦) billed 100% to patient. | |
| secondary_ffs_naira | No | Total tariff of secondary Fee-For-Service (FFS) procedures or specialist investigations in Naira (₦). |