We know you have lots of questions regarding the different types of health insurance plans available in Nigeria, we have taken out time to make this post answering in details popular questions users have always asked about health insurance in Nigeria.
What is HMO?
Health Maintenance Organization, abbreviated as “HMO” is a risk-sharing, contractual, cost-reducing, and schematic system of Health insurance. The HMO services are relatively high in developed countries like USA and developing countries like Nigeria.
The major goal of HMO is to ensure patients receive care and services from in-network primary care physicians, specialists, hospitals, clinics, and pharmacies except it is for out-of-area urgent care or emergency care.
How It Works
A HMO has a list of healthcare facilities that provide healthcare services to its clients at all levels of the country whether companies families or individuals. They render services to clients seeking to provide healthcare for its employees or members. Once an agreement is reached, the company or client pays the HMO a periodic amount known as premium (Just like in insurance this amount could be paid monthly or annually). The premium paid will fetch the beneficiary a coverage for provision of healthcare services subject to conditions within a certain period.
What is NHIS
The “National Health Insurance Service” is a Nigerian based health agency aimed at ensuring adequate and standard well being of the citizens at a low and cost efficient rate.
The National Health Insurance Scheme can cooperate with other private agencies, this act allows the HMOs to serve as agents to the NHIS and it envelopes both public and organized private sectors.
What is PPO
Preferred Provider Organization also known as just PPO is another type of health insurance plan where a group of medical providers are contracted to offer discounted medical services to subscribers, PPO has a network of health care providers they prefer you use but still allows you to choose providers outside the network.
PPO VS HMO?
Health Maintenance Organization restricts patients to a particular group of physicians called a network. While Preferred Provider Organization abbreviated as PPO allows patients to choose any physician they wish, either inside or outside of their network.
While PPO provides you with a wide and comprehensive coverage, it’s however more expensive than HMO plans.
How Many HMO Are There in Nigeria?
There are three levels of HMOs that operate in Nigeria:
- Those with National Structure, which are allowed to operate in all the 36 States of the country with the Federal Capital Territory inclusive.
- Those that operate within the confines of each of the six geopolitical regions of the country (north central, northeast, northwest, southeast, southwest and south-south).
- Those that operates within a given state.
How Much Does HMO Cost in Nigeria?
A HMO network plan called “Premium” is paid periodically for all the members or beneficiaries. The are different classes of premium with different benefits. The average HMO monthly premium is N126,500 annually which is lesser than the monthly plans.
HMO Companies in Nigeria
Presently, Nigeria has several health maintenance organizations that mediate on the hospital and patients behalf. Among others, the most popular HMO companies include:
- Hygia HMO
- Reliance HMO
- Health point HMO
- IHMS HMO
- AIICO HMO
- Redcare Health Service Limited
- Total Health Trust Limited.