The existence of large number and proficient health maintenance organization in Nigeria has allowed countless individuals to gain benefit. It has provided a new age in the healthcare and transformed how top health insurance is carried out.
There are numerous well-documented benefits of health maintenance organization insurance but it has certain drawbacks as well.
Advantages of health maintenance organization in Nigeria
- When an HMO goes in partnership with a network, the policyholders are beneficiaries of special benefits. The most important one is handling health care costs and keeping them under control. When not given adequate attention, health care providers can charge significant prices for their services. Health maintenance organization in Nigeria however, informs the healthcare providers in the network what they can and cannot charge. This helps users cutting away unnecessary costs.
- Most health maintenance organization in Nigeria have a diverse network of doctors. There is a very reasonable chance that one’s existing doctors are part of this network. Medical doctors often join in numerous popular health care centers that are close to them. Therefore, there are high probabilities to get the top health cover services from specialized doctors or specialists.
- In HMO in Nigeria, benefits covered are very detailed. However, in traditional plans, these can be insufficient and the prices of the plan vary.
- Health maintenance organization usually want a small sum of amount for medications. Health maintenance organizations help in reducing the cost of the drug by generally prescribing only the generic form of drugs and prescriptions. But in traditional health care, drugs may or may not be covered.
Read Also: 5 smart tips for online car insurance
Disadvantages of health maintenance organization in Nigeria
- One drawback of HMO in Nigeria is the restriction of providers in a certain network. If, however, one decides to go out of network, they may pay significant medical bills out of their own pocket. Therefore, you have to be very careful where you go for healthcare. The only exemption is when it is an urgent one have a However, you still have to be careful because the health maintenance organization might not come to an agreement with you about what makes up an emergency.
- The most HMO requires you to make a co-payment with each visit. If your problem gets worst, you may have to pay several payments to get everything taken care of. These costs can add up quickly.
- If you require specialized care you may have problems with a health maintenance organization in Nigeria plan. You are first required to obtain a network referral. If you secure a specialist outside the health maintenance organization insurance network or do not obtain a referral, any charges incurred with regard to this specialist will not be covered by your health maintenance organization insurance plan.
In conclusion, a health maintenance organization insurance plan needs adequate and proper consideration before going through with the adoption.