Updated November 2026: this post has been refreshed with current information for readers in Nigeria. It is general information, not professional medical or financial advice.
In October 2015 Novo Health Africa, a health maintenance organisation (HMO), hosted an executive symposium at the Intercontinental Hotel in Victoria Island, Lagos, as part of its healthy workplace series and to mark World Mental Health Day. The theme focused on helping executives tackle workplace mental strain to improve productivity. The event reflected two ideas that are even more important today: health is a business issue, and health insurance helps people get care before small problems become big ones. This guide explains how health insurance works in Nigeria.
How health insurance works in Nigeria
Health insurance in Nigeria is regulated by the National Health Insurance Authority (NHIA), which replaced the National Health Insurance Scheme under the NHIA Act of 2022. Most private health insurance is provided through HMOs. You or your employer pay a premium, and the HMO pays registered hospitals for covered services when you need care.
Types of health insurance plans
- Employer (group) plans: companies buy cover for staff and sometimes families.
- Individual and family plans: bought directly from an HMO.
- State health insurance schemes: many states run their own schemes, sometimes subsidised for vulnerable groups.
- Plan tiers: most HMOs offer basic to premium plans with different hospital networks and benefits.
What plans typically cover
Coverage varies widely, so read the benefits table carefully. Common inclusions are general consultations, basic tests, prescribed drugs from a list, minor surgeries, antenatal care and delivery on some plans, and emergencies. Higher tiers may add specialist care, dental and eye care, and larger annual limits. Exclusions often include cosmetic procedures, some chronic or pre-existing conditions during waiting periods, and fertility treatment.
How to compare HMOs
- Confirm the HMO is accredited by the NHIA.
- Check which hospitals are in the network, especially near your home and work.
- Compare annual limits, waiting periods and exclusions, not just the premium.
- Ask how pre-authorisation works for tests and procedures, and how fast approvals are.
- Read reviews and ask colleagues about claims and customer service.
- Check whether you can change your primary hospital easily.
Using your plan well
- Register your dependants and keep your ID card or digital card handy.
- Choose a primary hospital you can reach quickly.
- Call the HMO before non-emergency procedures to get authorisation.
- Use preventive benefits such as check-ups and screenings.
- Keep receipts and records in case of disputes.
- Escalate unresolved complaints to the HMO and, if needed, the NHIA.
Mental health at work
The Novo Health symposium highlighted workplace mental health, which has since become a major topic for employers. Stress, burnout, anxiety and depression affect productivity and wellbeing. Ask whether your plan covers mental health consultations, and employers can support staff with reasonable workloads, open conversations, access to counselling and leave policies that allow recovery.
For employers
Offering health insurance can help attract and retain staff, reduce absenteeism and improve productivity. Compare several HMOs, involve staff in choosing benefits, and review the provider's service each year.
Frequently asked questions
Is health insurance compulsory in Nigeria?
The NHIA Act 2022 aims to make health insurance mandatory for Nigerians and legal residents, though implementation is ongoing. Check NHIA guidance and your state scheme.
Can I buy health insurance as an individual?
Yes, many HMOs offer individual and family plans.
Does HMO cover pre-existing conditions?
Some plans cover them after a waiting period or with limits. Read the policy terms.