📋 Men's Health
NHIS & HMO Health Insurance in Nigeria
How to access health insurance and what it covers in Nigeria
The National Health Insurance Scheme (NHIS), now operating under the National Health Insurance Authority (NHIA), was established to make healthcare affordable for all Nigerians through risk pooling. Health Maintenance Organisations (HMOs) are the private companies that manage benefit plans under NHIS. Understanding how to enrol, what is covered, and how to use your benefits can significantly reduce out-of-pocket health spending — which currently accounts for over 70% of Nigerian healthcare costs.
When to Seek Help
Enrol nowIf you are employed in the formal sector — your employer should be deducting NHIS contributions; confirm your registration status with your HR department
Informal sectorThe Community-Based Health Insurance Scheme (CBHIS) and Vulnerable Group Social Health Insurance Programme (VSHIP) now allow informal workers, artisans, traders, and rural Nigerians to access subsidised insurance
Claims disputeIf a facility refuses to honour your HMO card or charges you for a covered service — escalate to your HMO first, then NHIA if unresolved
Tests & Diagnosis
🧪 Verify HMO accreditation
NHIA website (nhia.gov.ng) lists accredited HMOs and facilities — check that your chosen hospital is on your HMO's provider list before visiting
🧪 Pre-authorisation
Some procedures (major surgery, specialist referrals, expensive investigations) require pre-authorisation from your HMO — call the HMO helpline before the procedure
Frequently Asked Questions
Can I use my NHIS at any hospital?
No — you must use hospitals accredited by your specific HMO. If you go to a non-accredited facility (including emergencies where possible), you will likely pay out-of-pocket and seek reimbursement later.
What happens in an emergency at a non-HMO hospital?
Emergency stabilisation is legally required regardless of insurance status. Save all receipts and contact your HMO immediately — most have emergency out-of-network policies for genuine emergencies.
How do I enrol in NHIS?
Formal sector workers: through your employer. Self-employed/informal: approach your state's NHIA office or use the NHIA digital self-enrollment platform. You will receive a unique enrolment ID and be assigned a primary care provider.
Is my family covered under my NHIS?
Standard NHIS covers the subscriber, one spouse, and up to four biological children under 18. Additional dependants can be added at extra cost depending on the HMO plan.
What is the NHIA Basic Minimum Package?
The NHIA-mandated minimum package all accredited HMOs must provide: includes outpatient care, hospitalisation up to 15 days, antenatal and delivery care, essential medicines, and basic emergency care. Some HMOs offer enhanced plans above this minimum.