What Is Health Insurance?
Health insurance is a type of insurance coverage that typically pays for the medical, surgical, prescription drug, and sometimes dental expenses incurred by the insured. Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly. It is often included in employer benefit packages as a means of enticing quality employees, with premiums partially covered by the employer but often also deducted from employee paychecks. The cost of health insurance premiums is deductible to the payer, and the benefits received are tax-free, with certain exceptions for S Corporation Employees.
Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. Choosing a health insurance plan can be tricky because of plan rules regarding in- and out-of-network services, deductibles, co-pays, and more.
How Health Insurance Works
Health insurance can be tricky to navigate. Managed care insurance plans require policyholders to receive care from a network of designated healthcare providers for the highest level of coverage. If patients seek care outside the network, they must pay a higher percentage of the cost. In some cases, the insurance company may even refuse payment outright for services obtained out of network.
Many managed care plans—for example, health maintenance organizations (HMOs) and point-of-service plans (POS) require patients to choose a primary care physician who oversees the patient’s care, makes recommendations about treatment, and provides referrals for medical specialists. Insurance companies may also deny coverage for certain services that were obtained without preauthorization. In addition, insurers may refuse payment for name-brand drugs if a generic version or comparable medication is available at a lower cost. All these rules should be stated in the material provided by the insurance company and should be carefully reviewed. It’s worth checking with employers or the company directly before incurring a major expense.
Increasingly, health insurance plans also have co-pays, which are set fees that plan subscribers must pay for services such as doctor visits and prescription drugs; deductibles that must be met before the health insurance will cover or pay for a claim; and coinsurance, a percentage of healthcare costs that the insured must pay even after they’ve met their deductible (and before they reach their out-of-pocket maximum for a given period).
In Nigeria, the National Health Insurance Scheme (NHIS) was introduced in 2005 to ensure universal access to good health care services, by protecting families from financial barriers to health care, and ensuring the availability of funds to the health sector for improved services. The NHIS is to provide social health insurance in Nigeria where health care services of contributors are paid from the common pool of funds contributed by the participants of the Scheme. The amount/funds are pooled, allowing the Health Maintenance Organisations (HMOs) to pay for those needing medical attention. However, The NHIS currently caters mainly for public service workers and their families which constitute less than 10 %of the population. The private health insurance providers in the country have different health insurance packages targeted at Nigerians who are not covered by the National Health Insurance Scheme (NHIS). These private health insurance providers, however, need to undergo an accreditation process with the National Health Insurance Scheme. The List of Health Insurance Companies in Nigeria are:
- Hygeia Health Insurance
Hygeia HMO is one of the most reputable private health insurance companies in Nigeria. Their plans include Individual Plan, Family Plan, Senior Citizens Plan, Plan for Pregnant Women, SME Plan, Gym & Spa Plan.
- Clearline Health Insurance
They offer healthcare plans to satisfy the needs of individuals, groups, companies, and the public sector in Nigeria. The company offers different types of health insurance in Nigeria. They include:
Corporate Health Plan: This medical insurance covers typical ailments and medical procedures for corporate employees.
Family Health Plan: Beneficiaries of this plan can access healthcare at any of their chosen providers in Nigeria.
Individual Health Plan: This covers individuals with no pre-existing medical conditions
- AXA Mansard Health Insurance
AXA Mansard is one of the best companies providing different types of health insurance in Nigeria. They have broad access to close to 400 health providers across Nigeria. They consist of hospitals, dentists, and eye clinics. Besides, they also provide HMO plans and individual plans for families.
- LeadWay Health Insurance
Leadway has an Associate company called Total Health Trust Limited that manages its health care insurance coverage. They provide three options: silver, Gold, and Platinum.
- HCI Health Insurance
HCI Healthcare has its license from the National Health Insurance Scheme (NHIS). They provide quality and affordable health care services to various classes of Nigerians. Their health insurance plans include:
Retail Health Insurance Plan: This covers individuals and families needing access to quality and affordable healthcare services. Also, the package is affordable.
Corporate Health Insurance Plan: This plan is for employees of micro to large-sized organizations.
School Health Insurance Plan: This covers the health needs of students at all levels of education.
Senior Citizens Health Insurance Plan: This plan includes older people of 60 years and above.
Informal Sector Health Insurance Plan: This plan addresses the health needs of sectors such as artisans, markets, clubs, associations, and communities.
International Health Insurance Plan: This health insurance plan covers emergency and non-emergency situations in over 100 destinations across the world.
- Reliance HMO
Reliance HMO is a health insurance company that uses software, data science, and telemedicine to make health insurance delightful, affordable, and easier to access. They have a long list of hospitals that work with them across the six geopolitical zones of the country with health insurance plans for individuals families and companies.
7. Great Nigeria Insurance Plc
Great Nigeria Insurance Plc is a fully incorporated insurance company with visions of being the insurance company of choice for keeping promises to stakeholders.
Other Private Health Insurance Providers
Regenix Healthcare Services Limited
Regenix Healthcare Services Limited provides effective and efficient healthcare services that is affordable and accessible nationwide, using the best available people and technology.
Ronsberger Nigeria Ltd
Ronsberger Nigeria Limited is a Health Insurance Company responding to the healthcare needs of those in need of care with the aim to promote improved healthcare programmes nationwide.
Songhai Health Trust Limited
Songhai Health Trust Ltd is a well-equipped medical care delivery, duly accredited by National Health Insurance Scheme (NHIS), to carry-out healthcare insurance services to public and private sector employers, employees, and individuals.
Wellness Health Care Limited
Wellness Health Care Limited formerly known as Investcorp Medicare Limited is an insurance company in Nigeria providing services in corporate, family, individual health insurance coverage, emergency services and counseling.
Ark Insurance Group
Ark insurance group is the leading insurance group that offers motor insurance, health insurance, home insurance, travel, and life insurance. With head office in Lagos, Nigeria, we provide world-class insurance services and products to clients.
Healthstead is Nigeria’s first indigenously owned health marketing company, duly & fully registered to carry-out health insurance services on hospital management, medical outreach, DNA paternity testing, foreign/overseas medical treatments, etc.
Oceanic Health Management Ltd
Oceanic Health Management Limited is a healthcare insurance provider offering optimum services in mobile health insurance, medical screening, community-based health insurance scheme, and more.
Paramount Healthcare Services
Paramount Healthcare Services offers services in health insurance for schools, government organizations, companies, individuals, and families.
UNIC Health Special Services
UNIC Health Special Services provides medical insurance schemes, international medical insurance cover, and health plans for individuals and groups.