Is Accessible Health Insurance Scheme Possible in Nigeria?

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The Hidden Secret Unveil

In a country like Nigeria, affordable health insurance scheme is required especially the provisions made available by the Federal (NHIS) or State Government. For century many do not know how the Nigerian government has been supporting/subsidizing for healthcare services, and due to lack of this information to many of it citizen, many hospitals are taking advantage, therefore private patient end up paying outrageous medical bills they never plan for.  According to Yogi Berra – “If you don’t know where you are going, you’ll end up someplace else.” Despite the economic hardship in Nigeria, if you dont know where you are going, you may become a victim outrageous medical bills.  When you visit some hospitals in Nigeria, you may spend 75,000 to treat malaria and typhoid fever while a day admission on account of  typhoid fever and malaria may cost you up to 150,000 naira. Well, all fingers are not equal, however, wisdom is profitable. Health insurance scheme is a good back-up plan to prevent going bankrupt from this expensive medical bills.

Do you know – it saves you more money, energy and time to have a medical insurance policy than visit the hospital as a private patient?  

Ask your self:

  • How much was your last medical care?
  • How much does it cost to register antenatal care?
  • What about the cost of surgical procedure?
  • As a family head, how much have you spent on children’s medical care in the past one year?

Accessible insurance scheme of sorts is the National Health Insurance Scheme (NHIS) or State Health insurance Scheme (Many state in Nigeria now have its own insurance scheme). It is accessible because anyone can register with as low as 15,000 naira per enrollee valid for a year duration.

Who is Eligible to apply

  • Working individuals, their family members, dependants, members of police and armed forces, and higher education students of Nigeria are eligible for the scheme.
  • Any citizen of Nigeria, not falling into any of the above mentioned category, is also eligible for the scheme.

Documents Required

  • Completed application form
  • Applicable Proof of Insurance seeker’s age
  • Acceptable Proof of Applicant’s Identity
  • Proof of Residence
  • Proof of Employment/Enrolment
  • Passport size photos (as required)
  • Report of Medical analysis (if required)
  • Any other documents (as instructed)

How To Apply For The NHIS Scheme

For the Formal Sector:

  • The registration is to be done through accredited HMOs.
  • The processing of the health insurance programme takes about 90 days (3 months) before the participant can access healthcare services.
  • The registration and payment cover the employer, the spouse and four biological children below the age of 18.
  • An identity card will be issued as proof of registration.

For the Informal Sector:

  • Registration is done through accredited HMO’s.
  • The registration payment covers only the individual concerned.
  • An identification card will be issued after registration.
  • It takes 90 days after registration before accessing medical care

Note: Online registration link is temporarily unavailable.

Apply In Person :

  1. To apply for Social Health Insurance Scheme, the applicant must visit any of National Health Insurance Scheme Office in Nigeria.
  2. You can find the contact and address details in the following page: Link
  3. Visit the office and obtain an application form for Social Health Insurance Scheme from the relevant department.
  4. Complete the application form with appropriate information under relevant sections. Attest it with your signature once completed.
  5. Once completed filling the application form, make sure that you have attached all the documents listed in the “Required documents” section of this page including a passport photograph.
  6. Then, submit it in person to the relevant authority at the office. The officer will generate Remita Payment Slip. Currently, it will cost minimum of 45,000 naira for registration (that is 1 Principal enrollee and 2 dependants).
  7. Make the stipulated payment accordingly and if you are a family of 6 (i.e father, mother and 4 children), its will cost 15,000 * 6 = 90,000
  8. After submission, the application and other documents will be forwarded for examination and verification processes.
  9. Once the verification and validation processes are over, the application will be approved and the officials will proceed to take required steps for registration.
  10. Then, the applicant will be informed about the further tasks to be accomplished.

Benefits of The National Health Insurance Scheme

  • Insured contributors benefit maternity care for up to four live births.
  • Specific immunization programme for beneficiaries
  • Access to health care without payments
  • Free medical consultation
  • Beneficiaries enjoy health education counseling, family planning, antenatal and postnatal care.
  • Hospital care in a standard ward for a limited period of 21 days a year.
  • Maternity care for up to four live births for every insured contributor.
  • Preventive care immunization as it applies in the National Immunization Programme.
  • Consultation with specialists such as physicians, paediatrics, gynaecologists, surgeons, Prosthetics; Dental care and eye care etc.
  • Health education, family planning, antenatal and postnatal care.
  • Out-patient care.
  • Prescribed medicine (10% co-payment applies to drugs only)

Benefits Package

Over 95% of disease conditions that afflict us are covered by the NHIS.

Out Patient Services

    Consultations including reviews: Conditions treated at outpatient setting include the following:

  • Malaria, acute respiratory tract infection, diarrhoeal disease, skin disease and ulcers, hypertension, acute eye infection, rheumatism, anaemia, intestinal worms disorders, acute ear infection, typhoid fever, dental caries, diabetes mellitus, STIs, asthma and others (general and specialist)
  • Investigations, including laboratory investigations, x-rays
  • ultrasound scans for general and specialist out-patient services.
  • HIV/AIDS symptomatic treatment for opportunistic infections.
  • Out-patient/day surgical operations, including hernia repairs, incision and drainage of abscesses, and excision of lumps and haemorrhoidectomy.
  • Out-patient physiotherapy.
  • Medication, namely, prescription medicines on the National Health Insurance Scheme Medicines List, traditional medicines approved by the Food and Drugs Board and prescribed by accredited medical and traditional medicine practitioners.
  • Any other services approved by the Minister of Health.

In Patient Service

  • General and specialist in-patient care.
  • Investigations including laboratory investigations, x-rays and ultrasound scans for in-patient care.
  • Diagnosis and complications from other cancers, e.g. anaemia or obstruction
  • Surgical operations, including appendicectomy (removal of the appendix).
  • In-patient physiotherapy.
  • Accommodation in general ward.
  • Medication, namely, prescription medicines on the National Health Insurance Scheme Medicines List

Oral Health

  • Pain relief, which includes incision and
  • drainage, tooth extraction and temporary relief.
  • Dental restoration, which includes simple amalgam
  • fillings and temporary dressing.

Eye Care Services

  • Refraction.
  • Visual fields.
  • Scan.
  • Keratometry (measuring the curvature of the anterior surface of the cornea).
  • Cataract removal.

Maternity Care

  • Antenatal care
  • Deliveries (normal and assisted)
  • Caesarean section
  • Post-natal care

Emergencies

All emergencies are covered. These are crisis health situations that demand urgent intervention and include:

  • Medical emergencies and surgical emergencies
  • Paediatric emergencies.
  • Obstetric and Gynaecological emergencies including Caesarean sections.
  • Road Traffic Accidents.
  • Industrial and workplace accidents.

Exclusions

    The following health care services are not covered under the NHIS:

  • Rehabilitation other than physiotherapy.
  • Appliances and prosthesis including optical aids, hearing aids, orthopaedic aids and dentures.
  • Cosmetic surgeries and aesthetic treatment. However, reconstructive surgery, such as is performed on burns patients, is covered.
  • HIV antiretroviral medicines.
  • Assisted reproduction, e.g. artificial insemination and gynaecological hormone replacement therapy.
  • Echocardiography (a painless test that uses sound waves to create moving pictures of the heart to give information about the size and shape of the heart and how well it is working).
  • Photography (photographs taken in clinics/hospitals to give visual records of patients’ condition and operations to track progress of treatment for medical files of the patient).
  • Angiography (a procedure where a dye is injected into the blood vessels and a photograph of the vessel is taken).
  • Orthoptics (diagnosis and treatment of defective eye movements and coordination).
  • Dialysis for chronic kidney failure.
  • Heart and brain surgery other than those resulting from accidents.
  • Cancer treatment other than cervical and breast cancer.
  • Organ transplantation.
  • Medicines that are not on the NHIS Medicines List.
  • Diagnosis and treatment abroad.
  • Medical examinations for purposes of employment, school admissions, visa applications, driving license etc.
  • VIP ward accommodation.
  • Mortuary services.

 

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