All You Need To Know About Health Insurance Scheme In Nigeria

All You Need To Know About Health Insurance Scheme In Nigeria

health insurance scheme has come to help everybody have better health care services in Nigeria. It is an open secret that health care services in Nigeria have remained a problematic issue for some time now. Our health services are in dire need of serious upgrade. It is one of the very many aspects of the Nigerian economy that should be worked on. You can talk about the poor facilities and instruments available to hospitals, poor funding, non-payment of salaries of health personnel leading to series of industrial actions and many other deficiencies bedeviling the Nigerian health sector.

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These deficiencies aside, Nigeria has come some miles in health insurance. It is maybe the only aspect of the health sector that has not been grossly affected. People however are either still skeptical about the scheme or lack awareness and the resources to involve themselves in it. If you can afford health insurance and you have not started one for you and your family, then you in for a long thing. Get started today. If you are unaware of the existence of these schemes, then please be informed that health insurance is real and a rational venture. If however you are in conflict on the programme to use, you can check our list of trusted plans and choose anyone that suits you.

Our special focus is on the information you need to guide you effectively in making a choice today to become a part of a scheme. Hopefully, you will get enlightened at the end of this article. Here are tips to guide you and educate you on health insurance scheme in Nigeria.

What is Health Insurance?

Health insurance basically means ensuring that the payment for your medical bills won’t be a problem when you become ill. It is a way you pay for healthcare. Healthcare insurance generally means that subscribers of the scheme are protected and shielded from paying the full cost of their medical bills when they get sick. On registration, one selects a plan, pays the registration fees and subsequent monthly renewals.

On National Healthcare Insurance Scheme

This was established by act 39 of the 1999 constitution to provide easy and accessible healthcare plans for Nigerians at an affordable price. They are therefore in charge of healthcare services in Nigeria. They are set up to improve the access and utilization of the healthcare sector by attracting more resources to it. They sit at the driver’s seat of the insurance plans in Nigeria. Their objectives are:

  • To ensure that every family has access to good healthcare services.
  • To protect families from financial hardships of huge medical bills.
  • To limit the rise in the cost of healthcare services.
  • To ensure equitable distribution of healthcare costs among different income groups.
  • To maintain high standard of health care delivery services within the scheme.
  • To ensure efficiency in health care services.
  • To improve and harness private sector participation in the provision of healthcare services.
  • To ensure equitable distribution of healthcare services in the whole federation.
  • To ensure appropriate patronage at all levels of health care.
  • To ensure availability of funds to the health sector for improved services.

Without doubt the establishment of the scheme is a noble move from the government. The big issue remains the achievement of the said objectives.

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The Programs Of The Scheme Explained

There are basically two programs. The first one is the formal sector social health insurance scheme and the informal sector social health insurance scheme.

  1. Formal sector social health insurance scheme (FSSHIS): this scheme is for employees in the formal public and private sector in Nigeria. It goes further to cover for their spouses and four children below 18 years. Uniformed men in the military and para military are also included in this category.
  2. The Informal Sector: the informal sector includes the following:
  • Tertiary Social Health Insurance Program (TSHIP): this is meant for students studying in higher institutions in Nigeria (Universities, Polytechnics and colleges of education). This aims at catering for the qualitative healthcare services for students at the higher institutions.
  • Community Based Social Health Insurance Programme (CBSHIP). This platform caters for people in the villages, market women and men, retirees and families in communities.
  • Public Primary Pupils Social Health Insurance Program (PPPSHIP): this is meant for pupils in the primary schools across the nation (public primary schools) that are between the ages of 6 to 12. They are mostly children from the middle and lower class.

The Packages of Health Insurance Scheme in Nigeria

The two major packages of the health insurance scheme in Nigeria are the Health Management Organization (HMO) and Out Of Pocket (OOP). It should be noted that the Health management organization is better because it covers both the government and private sectors. This is possible because they liaise with the government to provide adequate and affordable healthcare services for NHIS subscribers.

The Benefits of National Health Insurance Scheme

  • Subscribers can receive maternity care for up to four children. That almost covers all your maternity issues and expenses.
  • Subscribers are also entitled to standard hospital care for a cumulative period of 21 days per year.
  • The scheme also provides customers with consultation with specialists such as physicians, pediatrics, gynecologists, surgeons, physiotherapists etc.
  • Subscribers also get immunization services from the scheme.
  • Health counseling on issues such as family planning, health education, ante natal and post natal care.
  • Out patient care is also extended to subscribers.
  • As a beneficiary of the scheme, you are to have access to healthcare without payment at the point of treatment.

What Does it Cost to Enroll in National Health Insurance Scheme

There is no static cost for enrolling in the scheme. It varies from programme to programme. The government pays the bill for formal sector social health insurance programme while the cost for other programs varies. If it is for spouse and children, it will cost 9000 naira per head to enroll in the NHIS program. VCSHIP cost 15,000 naira for registration and a further 10,000 naira per head fee while NMHIP costs 12,000 naira for registration and 9,000 naira per head.

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In conclusion, it is expected that you join a HMO today and start enjoying the benefits of the scheme. Make inquiries to know the one that is best for you. Don’t just talk to one HMO; talk to as many as possible so as to have a good basis for comparison. All the best dear.