Not long ago, a friend of mine woke up to excruciating stomach ache. He rolled on the floor, cried and vomited all he had eaten the previous night. His widowed mother rushed him to the hospital and soon after, he was diagnosed with acute appendicitis. He needed surgery, fast.
Impressively for a small Surulere hospital, he was successfully operated on that evening but he was lucky – his mother had health insurance through her work.
How does health insurance work in Nigeria?
Health insurance works in a similar way to other forms of insurance. You pay some money (called a “premium”) to the insurance company to cover you for certain stipulated incidents. If you fall sick, the insurance company pays for your medical expenses or reimburses your payments, depending on the nature of the agreement.
In Nigeria, health insurance for individuals/families is provided through health management organizations (HMOs). The National Health Insurance Scheme (NHIS) oversees the activities of HMOs and in 2014, re-accredited them to consolidate on quality medical services offered.
Am I covered for every illness under the sun?
Due to the complex nature of health issues, there are some important points to note regarding health insurance. Not all health conditions are covered by health insurance and certain others are only covered at extra cost.
You can get basic cover for a low premium (premium = annual payment) or a more robust cover for a higher premium. Basic cover usually includes things like general outpatient consultations, preventive care and counselling, in-patient care (admission days, nurse care etc), dental services, eye care etc
Higher priced health insurance plans come with added benefits such as covers for radiotherapy, chemotherapy, admission (longer admission days, private wards), maternity care (up to certain amounts), advanced eye care and surgery, annual routine medical check-ups etc.
Other important information to note:
- Certain health cases might be put on an ‘Exclusion list’ depending on the HMO. Cases such as cosmetic surgery, brain/heart surgery, chronic psychiatric disorders, prostheses, diabetes, drug abuse, addiction, self-inflicted injuries etc
- Some HMOs might conduct medical tests before enrolment into their plans.
- Generally, a younger non-smoking person with a healthy lifestyle is more likely to get lower insurance quotes than an older person with a medical history.
- Women on average tend to get higher health insurance quotes than men.
- HMOs usually have a hospital network (health providers) they work with. It is important to check the network of any HMO you have in mind. Proximity of health provider to home or workplace might help in decision making.
How much does it cost to get health insurance?
We were able to get quotes from six HMOs to give us an idea of health insurance costs. All HMOs listed cover most of the basics. Higher priced plans come with added benefits. The figures provided below are retail health insurance costs for individuals and families (Principal, spouse, 3-4 children)
- AXA Mansard Health Limited:
AXA Mansard provides four health Insurance plans; Bronze, Silver, Gold and Platinum. Annual premium per individual is; Bronze (₦39,134), Silver (₦57,343), Gold (₦104,188), and Platinum (₦282,227). To get any of these call Mr Kevwe on 08061214981, customer care on 08150649602 or email email@example.com.
- Expatcare Health Limited
Expatcare provides six retail health insurance schemes for individuals and families. These include; Essential, Bronze, Silver, Gold, Gold Plus and Platinum. Premium on these are Essential (₦16,950), Bronze (₦27,290), Silver (₦35,087), Gold (₦42,884), Gold Plus (₦79,100), Platinum (₦231,000). For families, annual cost are; Essential (₦67,800), Bronze (₦109,160), Silver (₦140,348), Gold (₦171,536), Gold Plus (₦316,400), Platinum (₦643,500).
Expatcare can be contacted on the following numbers 070442444444, 07088841740, 08136104900. Emails can be sent to firstname.lastname@example.org
- Healthcare International Limited
Health Care International has five health insurance plans on offer namely; Titanium Compact, Titanium Classic, Titanium Ultra, Titanium Deluxe, Titanium Royal. For individuals, premiums are: Titanium Compact (₦20,000), Titanium Klassic (₦25,000), Titanium Ultra (₦40,000), Titanium Deluxe (₦110,000) and Titanium Royal (₦175,000).
Family Titanium premiums: Compact (₦100,000), Classic (₦125,000), Ultra (₦175,000), Deluxe (₦400,000), Royal (₦650,000)
For more information contact Health Care International on 01-4489820, 08052099094-99, 08052099066.
- International Health Management Services Limited
There are four IHMS retail health plans for individuals and families. These are: Basic, Standard, Standard-Plus, and Comprehensive. Premiums on each of these plans (individual/family): Basic (₦23,000/₦115,000), Standard (₦49,300/₦246,500), Standard-Plus (₦70,400/₦352,000) and Comprehensive (₦125,000/₦625,000).
For more on these call 01-7301332, 07041446622, 08121010100 or email email@example.com
- Premium Health Limited
Insurance quotes from ehealthinsurance show three health plans for individuals and families. These are Premium Select, Premium Comprehensive, and Premium Platinum. Annual costs on these plans (per individual) are: Premium Select (₦27,500), Premium Comprehensive (₦48,200) and Premium Platinum (₦70,000).
To get any of these offers call 08099977488, 08077593130, 08077593132 or email firstname.lastname@example.org
- Clearline International Limited
Clearline family health package has a premium of ₦50,000 for the Gold plan and ₦35,000 for the Silver Plan. For more details about these plans call 08076490173, 01-7741092 or email email@example.com
Always endeavour to read through and understand the fine print before buying. You can also make use of health insurance provided at your workplace if available. This might be a cheaper option and offers the flexibility of premiums deducted from monthly salaries.
See full list of accredited HMOs and their contacts here.
Have questions or comments? Feel free to join the conversation below.
There are state health insurance schemes now in Nigeria with Lagos State Health Scheme LSHS being operated by the Lagos State Health Management Agency LASHMA as example. These are Social health programs that provides basic primary health coverage with additional chronic health management at affordable rates. The basic rate for the LSHS is N8500 for single and N40000 for a family of up to six (6) members. There agencies that help provide sales expertise to LASHMA in Lagos entity. The comment is posted by a sales agency for more information.
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