Health Insurance In Nigeria: Types Of Health Insurance, Benefits and How To Apply
One of the very few things most people in Nigeria usually take for granted is their health care. This is due to some other factors such as medical expenses that contribute to the less prompt medical check ups. Inevitably, health failures are meant to arise either planned for or not.
However, to be on the safer side, health insurance in Nigeria could satisfy this situation and alienate incessant medical risks due to lack of medical expenses.
Hence, health insurance in Nigeria is of much importance. It is a program that is publicly made available to most people by the government and other private insurance companies.
To lay emphasis on the importance of health insurance in Nigeria— assuming a family member had an accident. Understandably, you would be required to pay for the medical expenses.
In worst scenerios, you might not be financially bouyant to meet the doctor’s request for payment. In this situation, it might be dangerous for the victim and the other members of the family.
On the other hand, if there’s a health insurance already in place, such situation could be easily averted. The health insurance in Nigeria would cover it and you won’t be required to pay.
Although, it depends on the health insurance plan you applied for.
Hence, to take the necessary measures for unforeseen circumstances related to health, health insurance in Nigeria is worth of your consideration.
Now, let us consider the following on health insurance in Nigeria.
What Is Health Insurance?
Health insurance is a type of insurance that covers the surgery and medical cost of the policyholder, that is, the person who gets the medical coverage from the health insurance.
Like other countries, health insurance in Nigeria is offered by either the government or other insurance companies or bodies. For instance, in the United States, the government offers subsidized rates of health insurance to their citizens through insurance plan called Medicaid.
Hence, the insurer is the insurance company that offers the medical coverage while clinic, hospital or pharmaceutical stores which issues the treatment are described as the provider.
Just like it was stated earlier, the payment scheme depends on the actual or type of health insurance coverage. The medical treatment may either be paid for directly by the insurer or recovered by the policyholder after paying the medical bills.
Types Of Health Insurance In Nigeria
Having considered the meaning of health insurance in Nigeria, let’s also look at the available types of health insurance in Nigeria.
There are 7 different types of insurance plans
- Point of Service (POS)
- Exclusive Provider Organization (EPO)
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Health Reimbursement Arrangements (HRAs)
- Health Savings Account (HSA)
1. Point of Service (POS)
Point of Service is a type of health insurance in Nigeria that combines the features of Health Maintenance Organization and Preferred Provider Organization.
This type of health insurance plan allows the employee to choose a primary health care physician from the plan’s network providers.
Although, this is voluntary, there’s a possible of a more level of medical coverage if an employee decided to use any of the services referred by these physicians.
Also, these services rendered by referred primary care physician are not subject to the policy’s deductible.
However, if the employee decided to use the services of a non-network provider, they may be open to the risk of being subjected to lower level of coverage, submit a claim for reimbursement, deductible and pay upfront.
Point of service might serve as a good health insurance plan in Nigeria for those with small busnesses if their employees are in the following situations:
- If their employees need flexibility to choose physicians and other providers
- If their employees desire primary care physician in order to coordinate care
- Lastly, position of sale as type of health insurance in Nigeria may be beneficial if the employees prefer the balance of greater provider choice versus lower premiums.
2. Exclusive Provider Organization (EPO)
This type of health insurance in Nigeria is quite similar to Health Maintenance Organization (also another type of insurance in Nigeria).
This is due to the fact that there is already a network of physicians in place which the members are required to use. However, there are bound to use them during situations of emergency.
In addition, the members have a primary care physician that provides referrals to several in-network specialists. The members also have responsibility for small co-payment and potentially a deductible.
Choosing Exclusive Provider Organization as the desired type of health insurance in Nigeria might be beneficial to an organization if:
- There are employees who are able to find value with a small panel of providers
- There are employees who find it comfortable to shoulder higher costs for unplanned events.
- Another reason to consider before making your choice is if you show preference to the balance of less provide choice in exchange for lower rates.
3. Health maintenance organizations
Another type of health insurance in furtherance to the aforementioned is the Health maintenance organizations which necessarily requires the employees to include a primary care physician as part of their plan.
In addition, to see a specialist the employees are required to obtain a referral from their primary care physicians.
Health maintenance organizations is quite beneficial in the stance that it provides a more broader coverage for preventive services compared to other policies. Also, payment of deductible may not be necessarily requires before the commencement of the coverage.
However, this type of health insurance in Nigeria won’t cover employees who without authorization from their primary care physician go outside of their Network or in some cases of emergency situations.
This type of health insurance may be beneficial for an organization if the employees request for lower premiums, good preventive measures or like the trade-off of in-network services.
4. Preferred provider organizations
In this type of health insurance plan, employees are encouraged to use a specified network of doctors and hospitals in order to receive their medical treatments and needs at a subsidized rate.
Compared to the previous types of health insurance in Nigeria, in Preferred provider organizations, employees have a freedom of choice to choose to see any doctored that is within the network already specified.
Other things to note is that, this type of health insurance places a requirement that the employees have an annual deductible that must be met before the insurance company begins to cover their medical bills co-payment and coinsurance are also made available in certain conditions.
This plan may be a good health insurance option if the employees requires flexibility in choosing a physicians and other providers and they prefer the balance of greater provider.
5. Health Reimbursement Arrangements
This allows the employees to reimburse employees for qualifying insurance premiums and other out-of-pocket medical expenses. It also has a fixed cost, flexible features that can work for any employer or organization.
It also allows for individual insurance premiums or supplement your employer-sponsored group health insurance plan.
6. Health savings accounts
Another type of health insurance in Nigeria to consider is the health saving account. This is tax-advantaged savings account that is used in conjunction with an HSA-compatible high deductible health plan (HDHP) in order to pay for qualifying medical expenses.
One of the benefit of choosing this type health insurance is that it provides for the availability of choice for the employers to contribute to the account irrespective of whether they offer the same group policy or not— even though health savings account is a type of health insurance that can be attached to group health insurance.
Additionally, another advantage is the fact that the account goes with the employee once they leave the company.
This type of health insurance in Nigeria is beneficial to an organization if there’s already a large number of employees who have an health savings account. Also, if you prefer to have more control over your contribution to health benefits and can’t afford a low deductible health plan.
7. Indemnity plans
Indemnity is a type of health insurance plans which is also known as fee-for-service plans. It allows the insurance company to pay a predetermined percentage of the reasonable charges, or the average fee within a particular geographic area, for a given service, and the insured pays the rest.
Unlike most of the other types of health insurance, the services fee are defined by the providers and varies from physician to physician.
Hence, the insured are always left with the possible situation of meeting an unexpected medical bills. Their bills for a particular medical treatment clearly depends on how much the provider charges for the services rendered.
An indemnity type of health insurance is beneficial to the organization if the employees requires more flexibility in choosing their doctors and hospitals and are willing to pay higher exchange rate among many other available options.
How Health Insurance In Nigeria Works
Generally, the health system in Nigeria often times makes it quite challenging for someone to meet his or her medical routine or treatment.
This is due to some other underlying factors that contribute immensely to the poor system— factors such as poverty, poor health facilities, very few health officials and payment hike for medical treatment.
As a result, most people find it difficult to pay for their medical bills, most especially when the circumstances become unforeseen or unplanned for.
Hence, to avoid this and to allow us to meet some certain medical routine, health insurance in Nigeria is quite beneficial.
It allows the Insurance companies in Nigeria to cater for most of these payment needs by lessening the cost for a more affordable amount.
Health insurance in Nigeria works in such a way that the insured are allowed to pay upfront, that is, beforehand to a health insurance company. There are several payment options and plans available. Hence, there is choice to choose the plan that simply meets ones interest.
After doing the aforementioned, the insured allows you to share “risk” with lots of other people who are making similar payments.
Irrespective of the fact that sickness or medical emergency might not happen as expected in most situations, the money paid to the insurance company in Nigeria can still be used to cover the expenses of a small number of enrollees who get sick or are injured.
Hence, with this in place, one can easily alleviate the risk related to sudden medical treatment and emergencies.
Importance Of Health Insurance
The following are some of the common importance of health insurance in Nigeria:
- It alleviate the problems often attached to sudden medical treatment and emergencies
- It provides for essential pharmaceutical care
- It also provides for routine care
- It reduces cost of medical treatment.
Getting to understand what health insurance in Nigeria entails, the types of health insurance available to people and its importance can not be overemphasized. It ensure more safety among the people.