How To Sign Up For Health Insurance
Universal health coverage, is the provision to all people, of access to needed health services, of good enough quality to be effective, without any fear or risk of financial impoverishment.
Truth is, in our health system, we have not gotten any of the components right, there is still a lot of work to ensure coverage, as national coverage is still between 3–5% of the population. Access to needed health services is still a huge problem, especially with the rural-urban mismatch which means that health resources are not equitably distributed (Koller, 2019).
Perhaps the most important aspect is that of financial impoverishment in a society like ours where about 45.5% live in poverty. (World Poverty Clock, 2018)
In my previous article , I spoke about why Millennials Need Health Insurance. In truth, we all need health insurance, old and young alike. The big question is,
“How do I get access to health insurance?”
Before we get into that it is good to understand some basic terms/players:
HMOs: Health Maintenance Organisations are privately owned companies that aggregate various health insurance premiums from their clients (Companies, communities or individuals) into risk pools. They then purchase health services from HSPs (Health Service Providers), and often have a large and complex network of HSPs ranging from clinical, laboratory, pharmaceutical and diagnostic services. Basically, they are the middle men in health insurance.
NHIS: The National Health Insurance Scheme was established for the purpose of providing health insurance which shall entitle insured persons and their dependents the benefit of prescribed good quality and cost-effective health services as set out in this Decree. (National Health Insurance Scheme Decree, No 35, Part IV, of 1999 Laws of the Federation of Nigeria). The body plays a regulatory role in ensuring all goes well in the industry.
HSPs: Hospitals, labs, pharmacies and diagnostic centers that HMOs often partner with to deliver health services to enrollees.
Enrollees: the end user, the people signed up to health insurance packages.
Dependents/Beneficiaries: Depending on your health package, health insurance plans allow for a certain number of people to be added onto a person’s plan, with the primary enrollee being the Principal, and the others usually immediate family members, often elderly, or children below 18/21 years.
According to the Nigerian constitution, employers of labor with up to 10 employees may (the key word here is may, not must) enroll their employees in a health insurance scheme (National Health Insurance Scheme Decree, No 35, Part IV, of 1999 Laws of the Federation of Nigeria)
If you work in a company, or a formal setting, chances are that you have some form of health insurance.
Your company will most likely have teamed up with an HMO, and there will be different packages depending on your position in the company, you can ask to know the packages, premiums attached, benefits and exclusions. It also pays to find out if there is any other special arrangement like co-payments, or deductibles.
As an individual, probably in the informal sector, or a freelancer like Kene in my previous article, you can sign up for a health insurance package via:
The NHIS website. I just discovered it, and tried it out, and although I am yet to pay (I sent them an email asking for the benefits of the package, and I really want to ascertain how effective the process is), I was really impressed that there was a direct sign-up option from the NHIS website. The sign-up form, after I completed it, led me to a payment section, and I had the opportunity to pick my preferred health facility based on my location, and HMO. I counted 36 HMOs on that list, however, there are currently 34 accredited HMOs in Nigeria, with only one having full accreditation (Premium Times, 2018). There were 57 previously, 23 were delisted in 2018. I am yet to get my hands on the terms and conditions for full accreditation though, but I know a lot of the HMOs that are part of the 34 work just fine.
You can also go directly to any of the HMOs websites and sign up, their packages are usually listed, with the premiums, and the services covered. It is very important for you to pay full attention to what is covered and what is not. You can call the HMO directly and ask these questions, also, it is important to note that there will be a moratorium period (waiting time between when you sign up and pay for your health package, and when you can access services).
When picking an HMO, it is important to find out:
How extensive their HSP network is? (You can place a call through to find out, this may be important if your job requires a lot of travelling within the country)
How quickly they resolve problems (You can test this with a simple email/call to enquire about their services, a prompt response is a good indicator of the turn around time of the company)
What’s the word on the street concerning their brand? (Speak to existing enrollees if you can)
Running a service delivery company in Nigeria is hard, truth be told, but a commitment to ensuring delivery of quality services will always show.
Some digital banks like Piggy Vest have Health Insurance Features as well that you can explore.
The system is far from perfect in Nigeria, I still hope to see full integration of Government and Private facilities in the scheme. I believe that for people to enjoy the full extent of services, government hospitals must be listed on every HMO’s provider network. They are often the most widespread in terms of distribution, and most skilled, in terms of expertise, when it comes to managing complex cases and emergencies.
Having persevered to the end of this article, share it with a friend or two, purchase health insurance today, and sleep a bit better, knowing that if you need medical care, your wallet does not have to weep (so much, or weep at all!).
References
Koller, T. S. (2019). Rural poverty and health services:. Addis Ababa: WHO/HQ.
Premium Times. (2018, April 6). UPDATED: Nigeria sacks 23 of country’s 57 Health Management Organisations (HMOs). Retrieved from premiumtimesng.com: https://www.premiumtimesng.com/news/top-news/264172-nigeria-sacks-23-of-countrys-57-health-management-organisations-hmos.html
World Poverty Clock. (2018). The Percentage Of Nigerians Living In Poverty Could Increase By 2030. Retrieved from worldpoverty.io: https://worldpoverty.io/blog/index.php?r=12
