Health Insurance - Bridging the gap between the customer and health care
09/12/2018 By AskAwayHealth

Nigerian Health Insurance? Learn a few things here…

Nigerian Health Insurance has come to stay. Our health is our most important asset. But it can fail sometimes. This may be due to things that we can control and/or things that we cannot control. When our health fails it can be stressful and a burden – not just physically or mentally, but financially.


Why Health Insurance Matters

So we should do everything that we can to keep in health. This includes planning for when we fall ill. As our healthcare need may happen when we least expect, paying for healthcare out-of-pocket result in financial catastrophe for individuals and families.

The best way to prevent financial catastrophe from accessing health for yourself and your family is through a third-party payer subscription. Health Insurance is one of such third-party payers.


Do you have Nigerian Health Insurance?

IF NOT – WHY??


Basic Facts about Health Insurance

But how do you know which Health Insurance provider and plan that is good for you and your family? Below are some terms in the world of Health Insurance that you should know in helping you decide:

Health Insurance – this is when you make regular payments to an insurance company in order for them to pay for your health care bills when you need to access healthcare in the future.

Health Plan – this is a scheme you sign up to that itemises and determines the kind of treatment your Health Insurance provider will pay on your behalf. Various health plans exist tailored to the needs of different individuals, families or corporate organisations.

Health Maintenance Organisation (HMO) – these are companies that sell Nigerian Health Insurance plans. They are the ‘go-between’ healthcare users (individuals/ families/corporate organisations), and healthcare providers (accredited/validated clinicians and facilities often in a network). HMOs are accredited by the National Health Insurance Scheme(NHIS).

Provider – this is the healthcare facility that will provide your care when needed based on the health plan you have agreed/subscribed to with your HMO.     

How do the Providers work?  Usually, there is a list of providers (network) that you will be given by your HMO to utilise for your health care needs. Some HMOs limit you to using one health care provider for your primary needs; but in an emergency, you can seek health care from any hospital even if they are not on your HMO’s network – as long as you inform the HMO within 24-48 hours.

Cost of Health Care Plans – the cost of health plans varies from one HMO to another and from the type of coverage provided to the next.  When searching for an HMO from which to purchase a plan, you need to consider what best suits your needs, and what you can afford.

Health care costs are unpredictable – regardless of how young and healthy you are – it is better to be prepared. It is better to have Health Insurance for you don’t know when you will need health care.

Pre-existing Condition – It is important to declare to the HMO if you have a medical condition that has been in existence before you purchase a health plan.

Exclusions – every Nigerian Health Insurance company will list a group of medical conditions that cannot be covered under their plan. Please check with the HMO before you purchase a plan that you understand what it does and does not cover.


Selecting a Health Insurance Provider

So now you want to purchase a health plan! Where do you start?

Browse some HMOs from the list below, read through their website and perhaps contact them for updates:

Nigerian Health Insurance Providers (Health Maintenance Organisations):

  1. AxaMansard HMO
  2. Avon HMO
  3. Clearline HMO
  4. Hygeia HMO
  5. Metro HMO
  6. NHIS VCSHIP
  7. Redcare HMO
  8. Reliance HMO 
  9. Sterling Health HMO
  10. United Healthcare HMO
  11. Zenith Medicare HMO

Go through different providers to see which suits your personal situation. This may include cost as well as the care provision they offer.

Are you with one of these providers already? How would you rate your experience? Let us know in the comments below.

More Reading from our Blog:

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practicing Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org

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