ABSTRACT

This study investigates the role of health insurance in making healthcare services more affordable for patients in the Buea Municipality, Cameroon. The affordability of healthcare is a significant concern for many families in Cameroon, particularly those with limited financial resources. Health insurance schemes are designed to mitigate the financial burden associated with medical expenses by offering coverage for various healthcare services. This research aims to assess how effectively health insurance helps patients in Buea access affordable healthcare.

A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews. Data were collected from a sample of insured and uninsured patients attending healthcare facilities within the Buea Municipality. The study examined factors such as the out-of-pocket expenses, access to medical services, and the overall perception of health insurance among patients. Interviews with healthcare providers and insurance companies also provided insights into the operational challenges of health insurance schemes in the region.

Results indicated that patients with health insurance experienced a significant reduction in out-of-pocket expenses, especially for hospitalization, prescriptions, and diagnostic tests. Insured patients reported fewer instances of delaying or avoiding medical care due to cost concerns. However, the study also revealed several challenges. Many patients were unaware of the full extent of their insurance coverage, and some insurance plans had limited coverage or exclusion clauses that left patients with high medical bills. Additionally, issues such as bureaucratic delays in processing claims and inconsistent reimbursements were identified as barriers to effective health insurance utilization.

The study concludes that while health insurance plays a crucial role in improving the affordability of healthcare services for patients in Buea Municipality, there is a need for increased awareness and education on insurance coverage options. Insurance providers should also streamline their processes to ensure timely reimbursements and eliminate gaps in coverage. The government could play a more active role in promoting health insurance participation to enhance access to affordable healthcare across the municipality.

Keywords: health insurance, healthcare affordability, Buea Municipality, Cameroon, out-of-pocket expenses, insurance coverage, healthcare access, medical expenses.