Introduction
Health insurance is a contract that an insured party has with a health insurance company that requires the insurer to pay some of all of the insured party’s healthcare expenses in exchange for a premium. Health insurance is considered important to every individual. Due to the unfavorable economic climate in the country that puts a strain on disposable income, one can not afford to get ill or require medical attention without the means to pay out-of-pocket for medical expenses. Therefore, health insurance is aimed at ensuring that an individual does not ensure medical bills or miss out on specialized medical care requirements.
There are various health insurance policies that one can subscribe to achieve medical coverage. Preferred Provider Organization ( PPO) , Exclusive Provider Organization (EPO), Point-of-Service (POS), Catastrophic Plan, and Health Maintenance Organization (HMO) are avenues by which an individual could access health insurance.
Basically, a Health Maintenance Organization (HMO) is a system that gives health care coverage to subscribers for an exchange of fees that are deductible on a periodic basis, either monthly or annually, known as premiums. A Health Maintenance Organization (HMO) consists of a group of health providers that ensure that their subscribers adapt to coverage of medical care delivered through doctors and other health care providers who are under contract with the Health Maintenance Organization(HMO). This explicitly implies that a subscriber to a Health Maintenance Organization (HMO) is allowed to seek medical care only within the network of available doctors and healthcare professionals under the Health Maintenance Organization (HMO), as the insurer would not bear the responsibility of medical expenses should the insured party seek medical care from outside the network.
Health Maintenance Organizations (HMOs) have advantageous benefits to the insured party. First, there is a reduced cost of medical care which results as the insurer offsets medical bills ranging from surgery, prescription drug, and medical treatments, as permitted by the individual’s policy, incurred by the insured individual. Also, the premium rates of Health Maintenance Organizations (HMOs) are generally fixed on a periodic basis, either monthly or annually, and usually lower than other forms of health insurance. So, subscribers are guaranteed quality medical care from the Health Maintenance Organization(HMO) at affordable rates. Health Maintenance Organization (HMO) subscription could be individual coverage or corporate coverage.
There are some drawbacks of the Health Maintenance Organization (HMO) model of health insurance, however, when weighed against the benefits, it is pertinent to acknowledge that Health Maintenace Organizations (HMO) coverage is considered important to everyone These shortcomings include the following; subscribers usually are required to be within the scope of reach of the network of healthcare providers under the Health Maintenance Organization (HMO) to use the service. So, in the event where medical care is sought outside the network of healthcare providers under the Health Maintenance Organization (HMO), the insurer may not be liable to cover such expenses.
Health Maintenance Organizations (HMOs) are essentially driven by the private sector to bridge the gap in the healthcare delivery that the public sector healthcare falls short of.
It is important to put in mind these decisive points before consideration of a suitable Health Maintenance Organization (HMO) policy. They include; knowledge of the cost of premiums, area of coverage of medical care provided by the insurer, additional expenses that may accrue from seeking medical attention and care, such as copays and co-insurance fees.
A comprehensive list of accredited Health Maintenance Organizations(HMOs) that possess the eligibility to carry out health insurance services as determined by the National Health Insurance Scheme (NHIS) are listed below:
- Accessible ManageCare Limited HMO
- AIICO Multishield HMO
- Alleanza HMO
- Allied HMO Ltd.
- Anchor HMO
- Ankara Services Limited HMO
- Arewa Health Maintenance Services
- Ashmed Integrated Health Services Limited HMO
- Avon HMO
- Bastion HMO
- Capex Medicare Ltd. HMO
- Cignet Health Limited HMO
- Complete Medicare Ltd. HMO
- Clearline International HMO
- Defence Health Management Ltd. HMO
- Diamond Shield Health Services Ltd. HMO
- DHML (Military HMO)
- District Healthcare Ltd. HMO
- Doma Healthcare Ltd. HMO
- Eagle HMO
- Expatcare Health International Ltd. HMO
- Fountain Healthcare HMO
- ForteCare Limited HMO
- GNT Healthcare Nigeria Ltd. HMO
- Greenfield HMO
- Guardian HMO
- Hallmark HMO
- HCI Healthcare Ltd. HMO
- Health Assur Ltd. HMO
- Healthstone HMO Ltd.
- Healthcare International HMO
- Health Parkers Ltd. HMO
- Healthcare Security Ltd. HMO
- Hygeia HMO
- IHMS HMO
- Integrated Healthcare HMO
- International Health Management Services Ltd. HMO
- Ives Medicare HMO
- Kaduna GMD Healthcare Ltd. HMO
- KBL Healthcare Services HMO
- Lagos State Health Scheme
- Leadway Health HMO
- Liberty Blue/THT HMO
- Life Action Plus HMO
- Lifecare Partners HMO
- Lifeworth HMO
- Managed Health HMO
- Mansard Health Plan Nig. Ltd. HMO
- Marina Medical Serv. HMO
- Markfema Nigeria Ltd. HMO
- Maayiot Healthcare Ltd. HMO
- Medexia Ltd. HMO
- Mediplan Healthcare Ltd. HMO
- Metrohealth HMO
- MH HMO
- Mutual Benefits HMO
- National Health Insurance Scheme (NHIS)
- NNPC Health Maintenance Organization Ltd.
- Non Such HMO
- Novo Health Africa HMO
- Oceanic HMO
- Oluwa Health Trust Ltd. HMO
- Paramount Healthcare Services Ltd. HMO
- PHB Healthcare Ltd. HMO
- Phillips Health Management Services Ltd. HMO
- Pine Wood Medicare HMO
- Police Health Maintenance Ltd. (Police HMO)
- Precious Healthcare Ltd. HMO
- Premier Medicaid HMO
- Premium Private Health Trust Ltd. HMO
- Prepaid Medicare Service HMO
- Princeton Health Group HMO
- Procare Health Plan Nigeria Ltd. HMO
- Pro Health HMO
- Prudent Healthcare Management HMO
- Redcare Health Service Ltd. HMO
- Redstark HMO
- Regenix Healthcare Services Ltd. HMO
- Reliance HMO
- Roding Healthcare HMO
- Ronsberger Nigeria Ltd. HMO
- Royal Exchange HMO
- Royal Health Maintenance HMO
- Sahel Health Trust HMO
- Salus Trust GTE Ltd. HMO
- Songhai Health Trust HMO
- Sosocare HMO
- Sterling Health Managed Care Services Ltd. HMO
- Strategic Health Planners Co. Ltd. HMO
- Suna Health Nigeria Ltd. HMO
- Swift HMO
- Synergy Wellcare Medicaid Ltd. HMO
- Total Health Trust HMO
- Ultimate Health Management Services Ltd. HMO
- Unic Health Managed Care Services Ltd.
- United Comprehensive Health Managers Ltd. HMO
- United Health International HMO
- Universal Medical Services Ltd. HMO
- Venus Medicare HMO
- Walter Gates Nig. Ltd.
- Well Health Network Ltd.HMO
- Wellness/Investcorp Medicare Ltd HMO
- Wetlands Health Services Ltd. HMO
- Wise Health Services Ltd. HMO
- Zenith MediCare Ltd. HMO
- Zuma Health Trust HMO