Medical Insurance in Nigeria: 5 Things You Need To Know

Medical Insurance

Have you ever thought about Medical Insurance Before? How would you feel if you can go into a hospital and receive all treatments for whatever condition you might have, including Surgery & not pay a dime? Feels good right? Thats the benefit of Insurance.

TABLE OF CONTENT

A. BRIEF INTRODUCTION
B. IS THERE ANY FORM OF MEDICAL INSURANCE IN NIGERIA?
C. HOW DOES MEDICAL INSURANCE WORK?
D. WHAT IS THE IMPORTANCE OF MEDICAL INSURANCE?
E. QUALITIES OF A GOOD MEDICAL INSURANCE PLAN.
F. HOW DO I FIND A LEGIT MEDICAL INSURANCE COMPANY IN NIGERIA?
G. SUMMARY

BRIEF INTRODUCTION

Insurance is simply a means of protection from financial loss. In the medical context, Insurance is a means of protection from heavy expenses while seeking medical help. This is very important as many have died from coming late to the hospital because they thought their ailments were not so serious (Real fact is many Nigerians do not visit the hospital because they have no money).
The Nigerian healthcare system is ‘unique’. Most medical services are paid for by clients/patients from ‘out of pocket’. By out of pocket I mean using physical wads of cash or ATM card to pay for drugs, tests, procedures or even hospitalization in the hospital. Is this beneficial? Well, consider this event that happened weeks ago;

Medical Insurance
Medical Insurance. Image Credits: Mathrubhumi

“Mr Pantami is a bricklayer. He is also a family man and is very good at what he does. His wages come in a daily manner. Everything is smooth until the corona pandemic strikes. To contain it, the government imposes a restriction on movement. Pantami can’t go out to work and there’s little money at home. His young daughter Maria complained of headache and fever that comes and goes. Feeling the complaint was not so serious he buys an over the counter medication for her. Days later he wakes up to see her convulsing at night.
He quicky takes her to a hospital nearby but the heath workers on duty decline to attend to her unless her father pays for hospital card. Seeing that there’s no lean way, Patami rushes her to another hospital where she is stabilized. Tests are done and she is diagnosed with Severe malaria and Typhoid. She is well treated and within a few days discharged. But there’s a problem. She can’t leave the hospital if her bills are not cleared. Her dad can’t pay because he doesn’t have money. Because of the pandemic, he cannot work to raise the sum…”

This is one of the numerous challenges that face users of the Nigerian healthcare system daily.

B. IS THERE ANY FORM OF MEDICAL INSURANCE IN NIGERIA?

The answer is Yes. Government medical insurance and private medical insurance. The government medical insurance is offered by the NHIS i.e National Health Insurance Scheme which was established in 2004. It caters mainly for government workers and their dependents. Students in government institutions are equally covered by it. Though with its fair share of achievements and challenges, a large number of Nigerians lack access to these medical services hence the need for private alternatives.

C. HOW DOES MEDICAL INSURANCE WORK?

The client/patient finds a

  • i) credible medical insurance company (through their employer or directly) and goes through the health plans offered. You consider
  • ii) the services/cover (e.g hospital checkups/visits, hospitalization, eye and oral care, maternity care and most importantly emergencies) offered by such plans,
  • iii) states/areas such services can be obtained and
  • iv. the cost of each plan. After selecting your preferred plan, you
  • v) make an initial deposit (deductible) after which subsequent payments (premiums) would be made ( just like your DSTV or Recharge card subscription- Depends on the terms of the plan.) Periodic payments might be made monthly, quarterly or yearly.
  • vi) You’d be given a card or electronic Insurance number.
  • vii) Whenever you fall sick, visit an accredited hospital and you’d be treated for nothing (also depends on the kind of plan ) No one can turn you back like Mr Pantami in the aforementioned scenario when you have health insurance.
  • For the insurance company, they make money whenever you do not use those medical services.

D. WHAT IS THE IMPORTANCE OF MEDICAL INSURANCE?

  1. Better access to Quality Health Care for the client/patient.
  2. Saves healthcare costs for the client/patient.
  3. Makes you health conscious. Because you pay premiums, you wouldn’t assume a headache, fever or pain to be nothing. Why not use what you paid for?
  4. Places the client/patient in control during emergencies.
  5. Reduces death rate in Naija due to late presentation to the hospital.

E. QUALITIES OF A GOOD MEDICAL INSURANCE PLAN.

  1. It must be at a cost effective price. Premiums paid should be reasonable.
  2. It should cover the common health challenges in that locality. Services such as outpatient, inpatient service, oral and eye care, maternity care and even emergencies should be well stated if offered. The content of such a plan should be stated in simple terms. As the pidgin saying goes, ‘Local man has to understand’
  3. It should be renewable.
  4. A good medical insurance plan must offer the best possible services in credible facilities. Medical insurer must have a wide network of hospitals that recognize such plans. The states/areas where it can be used should be stated in plain language. Whether it is in Enugu, Jigawa, Bayelsa, Lagos, Abuja or even Yobe, it should be verified.
  5. Processes for claims and/or complaints should be easy and straight to the point. The goal is to improve the quality of healthcare delivery after all.

F. HOW DO I FIND A LEGIT MEDICAL INSURANCE COMPANY?

Aside providing medical insurance, the National Health Insurance Scheme also keeps a database of accredited private medical insurance companies. Information pertaining this can be found on www.nhis.gov.ng

Common private medical insurance companies in Nigeria include Hygeia HMO Ltd., Avon Healthcare Ltd., Greenfield Health Mgt Ltd., Regenix Health Services, Healthcare International Ltd., Ives Medicare, Allied HMO Ltd, Capex Expatcare Ltd. etc. Their accreditation status can be verified on the NHIS database.

G. SUMMARY

In Summary, access to good health is one of our rights as earthlings. Having a form of functional Health Insurance plan will help in addressing the present challenges we have in our present health care system. As our elders always say, ‘Pikin wey dey observe dey sabi when breadfruit wan fall’ i.e an informed person makes progress. All Nigerians must know this.

WRITTEN BY EDEANI CHIBUIKE DESTINY
UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ITUKU-OZALLA, ENUGU STATE.

Authors

  • Edeani Chibuike Destiny attended the College of Medicine, University of Nigeria Teaching Hospital, in ituku-ozalla, Enugu state, Nigeria.

  • Obasi Chinedu David attended the College of Medicine, University of Nigeria Teaching Hospital, in ituku-ozalla, Enugu state, Nigeria.

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