Debunking myths about healthcare insurance

The problem is not just that buying healthcare insurance is often complicated and even daunting. It’s also that there is a lot of confusing information out there, preventing many from finding a real healthcare insurance plan that’s the right fit. As the COVID-19 pandemic continues to affect people globally, you may agree with her words. What are people hoping to do?

Others have been so devastated by the pandemic that hope for a “normal” life seems far-fetched. For example, many have lost their job, their home, their good health or, worse yet, their loved ones in death. Of course, no one can predict exactly how the post-pandemic world will turn out. 

If you’re reading this quick guide, odds are you’re currently shopping for health insurance plan in Nigeria. Maybe it’s your first time and you’re unsure where to start and what to trust. Or maybe you’re thinking about switching your plan and finding a more wallet-friendly option. Regardless, we’re here to help simplify the shopping experience for you by cutting through the noise.

Below we’ve debunked the  major myths about health insurance. We hope this factual rundown can help you find a health insurance plan that saves you money and, ideally, provides just the right amount of healthcare coverage, where and when you need it most. 

1. A health insurance plan with lower monthly premium is the most wallet friendly option

In the short-term, this logic makes sense, but it’s not the smartest way to assess the value and cost-efficiency of a health plan. To make sure you get the most healthcare bang for your buck, evaluate health plans based on how much you’re going to pay over the course of the year when you add up premiums (your monthly payment to have insurance) and the costs you pay for medical services and drugs.

Even if two plans have the same premium, if one requires you to pay a lower cost for doctor visits and prescriptions, it could save you money in the long run. For example, some plans cover generic prescription drugs for free, which can save you hundreds of dollars annually compared with other plans with the same monthly premium.

Consider your healthcare needs for the whole year. This will help you select a plan that covers what you use most and avoid paying for extra plan perks.

2. I’m super healthy and young – do i still need health insurance?

So, you haven’t been to the doctor in years and don’t take any prescriptions. That means it’s smarter to just skip insurance altogether, right? Helpful Hint: it’s not smarter. Especially in the age of COVID-19. Moreover, there’s always the possibility of an emergency.

To give you an idea: at the average cost of a 3-day hospital stay is 50,000 naira and that’s before testing or surgery. You’re leaving yourself open to financial catastrophe without health insurance plan. A car accident or major unexpected illness can turn into bankruptcy in a matter of weeks.

Plus, there’s also a real psychological aspect to this. Every day you’ll need to worry about avoiding injury or illness—forget carefree skiing, travel, bike rides or commuting with germy passengers. That’s a heavy burden to bear, not to mention the cost of getting treated if you do crash or get sick.

Get a comprehensive health insurance plan, or risk saving a dime to spend a naira (or a few thousand)

3. All health plans are real health insurance

National Health Insurance Scheme (NHIS) compliant coverage refers to health plans that offer benefits for a broad-range of healthcare services that meet the requirements established by the NHIS Care Act.

Major health insurance companies, like Reliance HMO Health Plans, offer NHIS-compliant coverage. This coverage covers pre-existing conditions and guarantees access to essential health benefits like free annual wellness exams and preventive medications. There are also out-of-pocket maximums, which limits the amount you will spend in one year on medical expenses. Quality health insurance can save you from bankruptcy after a serious accident or illness.

And only NHIS-compliant plans are required to cover major laboratory testing and treatment at no cost to members. So make sure you’re buying the real thing when it comes to health insurance.

Buyer Beware: Health Care-Sharing Ministries (HCSM)

Health Care-Sharing Ministries are organizations in Nigeria whereby health care costs are shared among members who have common ethical or religious beliefs. While HCSMs may offer affordable coverage, they do not offer real health insurance. They are not regulated by the Department of Insurance, and do not guarantee essential health benefits or coverage for pre-existing conditions and may have limitations on what they will cover. Which means they can deny you coverage or drop you off the plan if you get sick or hurt, or deny covering you for anything related to a pre-existing medical condition.

They often have fixed annual limits on how much they will pay, leaving you on the hook if you have a big hospital bill. They also do not have partnerships with network hospitals, so you are on your own to negotiate healthcare costs. Many hospital facilities do not accept these plans for this reason.

4. Health insurance is simply too darn expensive!

Certain health insurance plans can be super expensive, absolutely, but there are many wallet-friendly options out there, like a Standard/Bronze or Silver Plan.

Are you under the age of 30 and healthy? Consider buying a Silver Plan. With a lower premium and essential healthcare benefits, a Silver Plan covers what you need most, protecting your wallet in case of an unexpected emergency. The difference between a Silver Plan and, say, a Silver Plan, could amount to hundred thousands of naira over the course of the year.