Top 20 Health Insurance Companies in Nigeria

 


Health insurance is a type of insurance coverage that pays for medical and surgical expenses of an insured individual. It providing financial protection to individuals and families against the high costs of healthcare, including doctor's visits, hospital stays, prescription drugs, surgical operation, and other medical services. 

Health Insurance Companies

Health companies are insurance companies that provide health coverage products for individuals.

Health insurance companies offer various plans and policies designed to meet the healthcare different needs of their customers.

General Services of Health Insurance Companies

Here are some key services provided by health insurance companies:

Premiums

Health insurance companies charge a regular premium in exchange for coverage. This premium can be paid monthly, quarterly, or annually, depending on the policy terms. The premium amount typically varies based on factors such as the insured person's age, location, and the level of coverage chosen.

Coverage Options

Health insurance companies offer a range of coverage options to cater to different needs. These may include individual plans, family plans, group plans for employers, and government-sponsored programs like Medicaid and Medicare.

Network of Providers

Most health insurance companies have a network of healthcare providers, including doctors, hospitals, and clinics, with whom they have negotiated discounted rates. When you use in-network providers, you generally pay less out of pocket for covered services.

Deductibles

A deductible is the amount you must pay out of pocket before your insurance coverage kicks in. Health insurance companies offer policies with different deductible levels, allowing you to choose a plan that aligns with your budget and needs.

Copayments and Coinsurance: Copayments are fixed amounts you pay for certain services, such as a doctor's visit or prescription drugs. Coinsurance is a percentage of the cost of a covered service that you are responsible for after meeting your deductible.

Preventive Care

Many health insurance plans cover preventive services at no cost to the insured, including vaccinations, annual check-ups, and screenings for conditions like cancer and diabetes.

Prescriptions

Health insurance companies often provide coverage for prescription medications, with varying levels of cost-sharing. This can include a formulary, which lists the drugs covered by the plan and their associated costs.

Customer Service: Health insurance companies offer customer support to help you understand your policy, find in-network providers, and address claims and billing issues.

Wellness Programs

Some health insurance companies offer wellness programs and resources to help individuals and families maintain a healthy lifestyle. These may include discounts on gym memberships, smoking cessation programs, and online health tools.

Claims Processing

When you receive medical care, you or your healthcare provider will submit a claim to your health insurance company. The company processes these claims, determines the amount it will pay, and sends an Explanation of Benefits (EOB) to you explaining the coverage and any remaining costs.

Emergency Coverage

Health insurance plans typically cover emergency medical services and hospitalizations, ensuring that you receive prompt care in critical situations.

Health and Wellness Information: Many health insurance companies provide resources and information on maintaining good health and managing chronic conditions.

It's essential to carefully review and compare health insurance plans to choose one that aligns with your healthcare needs and budget. The specific services and benefits offered by health insurance companies can vary widely, so it's important to understand the terms and conditions of your policy and ask questions to ensure you have the coverage you need.

Types of Health Insurance

There are two types of health insurance 

Private health insurance, and 

Public health.

There are also more specific types, which are often regarded as plans. 

Private Health Insurance

This type of health insurance is health insurance coverage provided by private health insurance companies and healthcare providers, and paid for by private individuals (the insured)

Public, or Government Health Insurance

With this type of insurance, the state subsidizes healthcare in exchange for a premium. The agency is charge of this type of health insurance in Nigeria is known as National Health Insurance Scheme (NHIS). For now the NHIS provides health insurance coverage for only those in government employment, although the NHIS Acts makes provision for social health insurance coverage for all Nigerians.

Insurance Plans

Managed care plan

In a managed care plan, the insurer partners with healthcare providers to provide lower cost medical care to its policyholders. There will be penalties and additional costs added to out-of-network hospitals and clinics, but they will provide some treatment.

The more expensive and comprehensive the policy, the more flexible it is likely to be with the network of hospitals.

Indemnity, or Fee-for-Service Plan

A Fee-for-Service plan covers treatment equally among all providers, allowing the policyholders to choose their preferred place of treatment. The insurer may pay up 80% of costs on an indemnity plan, while the insured foots the remaining costs as a coinsurance.

Health Maintenance Organization Plans

These are organizations that provide medical care directly to the insured. The policy usually has a dedicated primary care physician or clinic that will offer all necessary care.

Health Maintenance Organization (HMO) plans will usually only fund treatment referred by a family doctor and will have negotiated fees for each medical service to minimize costs. This is usually the cheapest type of plan.

Top Health Insurance Companies in Nigeria

AXAM Insurance

Avon MHO

Clearline Health Insurance

Hygeia Health Insurance

Dove Insurance Brokers Limited


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