Health Insurance in Nigeria: All You Need to Know

When the word ‘insurance’ is comes into discussion, many questions comes along with it; and that’s regardless of any form of insurance that’s being discussed. Although, Health care provision in Nigeria needs a serious lift, the insurance aspect of it hasn’t been badly affected.

For those who want to know some basic relevant info about health insurance in Nigeria, then read on as you would definitely find this write up very useful for you in the long run.

What is health insurance?

Basically, health insurance is a way to pay for healthcare. This payment protects a subscriber from paying the full cost of medical services when they are sick or injured. Just like car or home insurance, one selects a plan, pay the correlating monthly fee and the health issuer agrees to pay a portion of a subscribers medical cost. They basically negotiate the doctors and hospitals.

What about health insurance in Nigeria?

Health insurance in Nigeria is handled by the Nigerian National Health Insurance Scheme (NHIS) which is planned to attract more resources to the health care sector and improve the access, resources, and utilization of healthcare services.

What are the packages?

In Nigeria, there are two main packages which are the Health Management Organization (HMO) and the Out Of Pocket (OOP). The HMO plan is popular and better, as it covers both the tiers of government and private sectors, since the HMOs are being liaised with by the government to provide health care services to NHIS subscribers.

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What are the programs?

Formal Sector Social Health Insurance Programme (for employees in the public sector and organized private sector – a company with 10 staffs and above). Formal sector covers staff, spouse and four biological children.

National Mobile Health Insurance Program (NMHIP)which is in partnership with Telecommunications Companies in Nigeria and gradually phasing out the Voluntary Contributors Social Health Program (VCSHIP)

Tertiary Social Health Insurance Programme is for students in tertiary institutions.

Community Based Social Insurance for people in villages, markets, etc.

What are the benefits?

Some of the benefits of subscribing to the NHIS include:

  • Hospital care in a standard ward for a stay limited to cumulative of 21 days per year.
  • Maternity care for up to four (4) live births for every insured contributor
  • Consultation with specialists such as physicians, paediatrics, gynaecologists, surgeons, physiotherapists, etc.
  • Preventive care immunization as it applies in the National Immunization Programme.
  • Health education, family planning (counselling), antenatal and post natal care.
  • Out-patient care, including necessary consumables (Drugs, Injections, drips), and so on.

How much does it cost?

The cost for enrolling for the NHIS varies from programme to programme. The government organization bears the lump sum for the registration of Formal Sector Health Insurance Programme and your personal input depends on the Health Service Provider. Registration of your dependants (Children and Parents) usually cost around N9,000 per head.

VCSHIP costs a registration fee of N15,000 and a N10,000 per head fee. NMHIP costs N12,000 and N9,000 per head.

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All fees would be renewed annually.

How does one enroll?

To enrol for the Formal Sector Health Insurance Programme, one just needs to make enquiries of the HMO the firm uses and go register to get the enrolee card.

For the NMHIP, one has to contact NHIS in any of their branches which can be found online. Although one needs to visit them physically during the registration process, and after, to get ones’ card.

Issues

Of course in Nigeria, HMOs staffs are not well trained and they tend to see people who have chosen to insure their health as lower to those who didn’t chose to. Since they pay lower and enjoy insurance benefits. Hence, they tend to attend to them in a different manner compared to others.

Conclusion

The government should invest more in the health sector and give out loans to partnering HMOs so that their Health Services can be up to standard.

Also they should take time out to enlighten the staffs on the real line behind deciding to opt for health insurance and deciding not to as most people who have opted for it are even more enlightened and most times richer than those that didn’t.

Note: Private Health Insurance companies like AGA, HYGEIA and so on are still regulated under the NHIS.


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