A single medical emergency in Nigeria can wipe out years of savings. With hospital bills running into hundreds of thousands or even millions of Naira, health insurance isn't a luxury—it's financial protection your family needs.
This comprehensive guide explains everything you need to know about health insurance in Nigeria: how HMOs work, what plans cost, what's covered, and how to choose the best health insurance for your needs.
What is Health Insurance?
Health insurance is a type of coverage that pays for medical and surgical expenses. In Nigeria, most private health insurance is provided through Health Maintenance Organizations (HMOs).
Instead of paying huge hospital bills out of pocket, you pay a smaller monthly or annual premium, and your HMO covers your medical costs (within the limits of your plan).
Types of Health Insurance in Nigeria
1. National Health Insurance Scheme (NHIS)
The NHIS is a government-run scheme primarily for federal employees. It's being expanded to cover more Nigerians, but current coverage is limited.
- Mandatory for federal government employees
- Employer pays 10%, employee pays 5% of basic salary
- Covers employee, spouse, and up to 4 children
2. Private Health Insurance (HMOs)
Private HMO plans offer more flexibility and often better coverage than NHIS. Popular options include:
- Hygeia HMO - Wide hospital network
- Leadway Health - Comprehensive plans
- Reliance HMO - Tech-enabled services
- AXA Mansard Health - Premium coverage
- Avon HMO - Affordable family plans
How Much Does Health Insurance Cost in Nigeria?
Health insurance premiums in Nigeria vary widely based on coverage level, age, and provider. Here's a general breakdown:
Basic Plans
₦30,000 - ₦80,000/year
Coverage includes:
- Outpatient consultations
- Basic diagnostic tests
- Common medications
- Limited hospital admission
Best for: Young, healthy individuals
Standard Plans
₦80,000 - ₦200,000/year
Coverage includes:
- Everything in Basic plus:
- Specialist consultations
- More comprehensive tests
- Surgery coverage (limits apply)
- Better hospital network
Best for: Families, those with pre-existing conditions
Premium Plans
₦200,000 - ₦500,000+/year
Coverage includes:
- Comprehensive coverage
- Major surgeries
- Premium hospital access
- International coverage options
- Dental and optical care
Best for: Executives, comprehensive family coverage
What Does Health Insurance Cover?
Most HMO health plans in Nigeria cover:
| Usually Covered | Often Excluded |
|---|---|
| Doctor consultations | Pre-existing conditions (waiting period) |
| Hospital admission | Cosmetic procedures |
| Laboratory tests | Fertility treatments |
| Prescription drugs | Experimental treatments |
| Emergency care | Self-inflicted injuries |
| Maternity (on some plans) | HIV/AIDS (varies) |
💡 Important: Waiting Periods
Most HMOs have waiting periods before certain benefits activate:
- General illness: Immediate - 30 days
- Pre-existing conditions: 6-12 months
- Maternity: 9-12 months
- Major surgery: 3-6 months
Don't wait until you're sick to buy health insurance!
How to Choose the Best Health Insurance
- Assess your needs: Single or family? Any pre-existing conditions? Preferred hospitals?
- Check hospital network: Ensure your preferred hospitals are covered
- Compare coverage limits: Look at annual limits, not just premiums
- Read exclusions carefully: Know what's NOT covered
- Check claims process: How easy is it to access care?
- Consider customer reviews: Check how they handle claims
Top HMOs in Nigeria Compared
| HMO | Starting Price | Hospital Network | Rating |
|---|---|---|---|
| Hygeia | ₦35,000/yr | 1,500+ hospitals | ⭐⭐⭐⭐ |
| Reliance | ₦40,000/yr | 1,000+ hospitals | ⭐⭐⭐⭐ |
| AXA Mansard | ₦50,000/yr | 2,000+ hospitals | ⭐⭐⭐⭐⭐ |
| Leadway | ₦45,000/yr | 1,200+ hospitals | ⭐⭐⭐⭐ |
⚠️ Don't Skip Health Insurance
Medical emergencies don't warn you. A single hospital admission can cost ₦500,000 to ₦5,000,000+. Health insurance that costs ₦50,000-₦100,000/year is a small price for peace of mind.
Frequently Asked Questions
Can I get health insurance with a pre-existing condition?
Yes, but there's usually a waiting period (6-12 months) before that condition is covered. Some plans may charge higher premiums.
What happens if I need treatment at a hospital not in my network?
Emergency care is usually covered at any hospital. For planned treatment, you may need authorization or you might have to pay out of pocket and seek reimbursement.
Is health insurance worth it in Nigeria?
Absolutely. One hospital admission can cost more than years of premiums. Health insurance provides financial protection and ensures you get care when needed without wiping out savings.