Nigerian National Health Insurance Scheme

The National Health Insurance Scheme in Nigeria was founded on 10th May 1999. When the Federal Military Government established the National Health Insurance Scheme Decree No. 35 of 1999 Laws of the Federation of Nigeria.

This was arranged towards providing National health insurance for the citizens, their dependents and have them profit from prescribed good quality and cost-effective health services as set out in the decree.

Nigeria National health Insurance

Goals of National Health Insurance Scheme is to:

  1. Guarantee that every Nigerian citizen has access to good quality health care services.
  2. Protect families from the financial adversity of huge medical bills.
  3. Limit or reduce the rise in the cost of healthcare services.
  4. Ensure equitable circulation of health care costs amongst diverse income groups.
  5. Sustain a high standard of healthcare delivery services within the National Health Insurance
  6. Ensure efficiency in the delivery of healthcare services.
  7. Improve and harness private sector participation in the provision of healthcare services.
  8. Provide adequate distribution of health facilities within the Federation.
  9. ensure equitable patronage of all levels of health care.
  10. ensure the availability of funds to the health sector for improved services.

The National Health Insurance Scheme is responsible for registering every health maintenance organization and health care provider under the scheme.

Read Also: Nigeria Health Insurance: Benefits, costs & registration

The Scheme is also an entity which can sue or be sued in its name. The benefits of the National Health Insurance Policy are that the contributions paid cover healthcare benefits for the employee.

Any health care provider registered under the National Health Insurance scheme should render the following services based on the capital payment or approved fees in respect of each insured person registered with it:

  • Out-patient curative care including prescribed drugs and diagnostic tests,
  • maternity care up to four (4) live births under the age of 18 for every insured person.
  • preventive care which includes immunization,
  • family planning, antenatal and postnatal care,
  • consultation of some defined range of medical specialists (such as physicians, pediatricians, obstetricians etc.
  • Eye examination and care (excluding tests and provision of spectacles).

The above-mentioned services are covered in the national health insurance scheme through authorized healthcare providers in Nigeria.

Read Also: How to identify fake Insurance companies in Nigeria

How Successful Has National Health Insurance Scheme Been Since Its Inception?

Till date, the scheme has only been able to reach about 5 million Nigerians according to record. What happened to the remaining 165 million citizens in the country?

The National Health Insurance Policy or Scheme presently targets the formal and self-employed sector which has not really been covered. Recently, the National Health Insurance scheme has planned to cover more of the citizens in the rural areas by launching the Rural Community-based Social Health Insurance Scheme.

Most Nigerians have been reluctant in registering into the National Health Insurance Scheme for reasons I cannot measure. The registration should be made mandatory so as to reach out to as many citizens as possible.

Read Also: Nigeria locations of HMO Health Maintenance Organization

Once you have your health Insurance Scheme’s card. It will be easier to access medical care within the country without the need to go with cash to the hospital.  There have been some cases of Nigerians being refused treatment in hospitals. Because they could not make an initial down payment at the time of their arrival at the hospitals.

How Is This National Health Insurance Scheme Funded?

The National Health Insurance Scheme (NHIS) is funded primarily by contributions from members based on their respective income. For Formal Sector, Social Health Insurance Program contributions are premiums that make 15% of an individual’s basic salary. Where the insured person’s employer contributes 10% while the employee pays 5% for coverage of themselves, their spouse, and up to 4 children under the age of 18.