Nigeria Health Insurance – All you need to know about Nigeria Health Insurance Scheme (NHIS)

This article will walk us through on all you need to know about Nigeria Health Insurance Scheme (NHIS)

The National Health Insurance Scheme (NHIS) is a corporate body established under Act 35 of 1999 Constitution by the Federal Government of Nigeria to improve the health of all Nigerians at an affordable cost.

However, NHIS is to provide social health insurance in Nigeria where contributors ‘ health care services are paid out of the general pool of funds provided by Scheme participants.

Furthermore, it is also a pre-payment plan where participants pay a fixed sum regularly. The amount/funds are pooled so that the Health Maintenance Organizations (HMOs) can pay for those in need of medical care. It is essentially a mechanism of risk sharing that can boost the allocation of capital and equity. Yes, it is considered the most commonly used method of funding for health care throughout the world.

In addition, NHIS controls HMO-operated private health insurance. HMOs should have a hyperlink to the HMOs list on the web. Health Insurance is a social security system that guarantees that individuals are provided with the appropriate health services at regular intervals by making nominal contributions.

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Objectives of the National Health Insurance Scheme (NHIS)

  • Ensuring equitable distribution of health care costs among different income groups
  • For appropriate patronage of all levels of health care
  • Improving and harness private sector participation in the provision of health care services
  • It makes sure there is an equitable distribution of health facilities within the Federation
  • Limiting the rise in the cost of health care services
  • Maintaining high standards of health care delivery services within the Scheme
  • Making sure health care services are efficient
  • Protecting families from the financial hardship of huge medical bills
  • To ensure that every Nigerian has access to good health care services
  • To make available funds to the health sector for improved services

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Programs of the National Health Insurance Scheme (NHIS)

To ensure that every Nigerian have access to good health care services, the National Health Insurance Scheme has developed various program to cover different segments of the society and these includes;

1. Formal Sector which consists of

i. Formal Sector Social Health Insurance Programme

The Formal Sector Social Health Insurance Programme is a social health security system in which the health care of employees in the Formal Sector is paid for from funds created by pooling the contributions of employees and employers

The Formal Sector consists of the following;

  • Public Sector
  • Organized Private Sector
  • Armed Forces, Police, and other Uniformed Services

Membership

Employees of the public sector and organized private sector organizations employing ten (10) or more persons shall participate in the Program

Registration

Anyone who falls under this category has nothing much to do because the employers will have to register their employees. However, at the end of every month, a certain percentage of your salary will be deducted as your contribution, for the benefit of you and your family.

ii. The National Mobile Health Insurance

Another initiative is a public health plan / affordable health insurance scheme that enables mobile network users to enjoy social health insurance coverage offered by approved health management organizations (HMOs) with services provided throughout the country by NHIS certified healthcare providers

Membership

Nigerians or legal residents above 18 years that have a registered GSM telephone line from any of the Mobile Network Operators (MNOs). Nigerians/legal residents below the age of 18 years may be enrolled by their parents/guardians as adoptees

Benefits

This unique IT-driven program takes advantage of the country’s high teledensity and enables Nigerians to subscribe to a mobile phone health insurance package. The IT platform allows a customer to enroll with unprecedented ease, pick HMO & healthcare provider, and make premium payments, etc.

However, another unique feature of this system is the versatility of premium payment, allowing the premium to be charged on an annual, quarterly, weekly or daily basis, using airtime, Tailored Product Voucher (TPV) in addition to other electronic payment platforms

Registration Procedure

The process of enrollment is started by dialing *616# on any mobile network on the mobile phone. This action will activate the USSD menu that will take you through the entire process and enable you to enter your biodata, select your preferred Health Management Organization (HMO) & Health Care Facility, as well as the regular payment schedule.

In conclusion, successful completion of registration is verified by the issuance of an e-ID, sent via an SMS on the mobile used for registration Although the registration unit under the NMHIP is individual, an enrolled person may register an unlimited number of persons as adopted dependants

iii. Voluntary Contributors to Social Health Insurance Programmes (VCSHIP)

Here’s another health insurance that’s picked up and paid out at the discretion of eligible people or at the discretion of employers on behalf of workers in companies with less than ten employees. It is a program designed for those not currently covered by any of the NHIS initiatives and those not happy with traditional health care services.

A plan shall have full or partial compensation of programs omitted from the federal health system or not fully covered by it.  Community health insurance premiums are not risk-related, and voluntary donors ‘ access to health care is always contingent on evidence of donation.

Family members are not covered as co-insured by persons voluntarily insured in the social health insurance scheme in Nigeria. NHIS’s enabling law defining the Scheme and Operational Guidelines refers to this group of people as a large number of financially viable Nigerian businessmen and women with staff strength of less than 10 but could not be classified under OPS and not yet covered.

An effective self-employed individual not protected by CBSHIP but willing to participate in the program.
Retirees who wish to continue their political office under the NHIS Formal Sector System Foreigners living in Nigeria (legal residents), etc

Membership

Membership is voluntary and covers interested persons, families, establishment employers with fewer than 10 employees and active self-employed persons, three-tier political office holders and retirees not currently covered by any of the NHIS prepaid programs.  Others are Nigerian immigrants or temporary residents and Diaspora Nigerians

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2. Informal Sector which consists of

i. Tertiary Institution Social Health Insurance Programmes

The Tertiary Institutions Social Health Insurance Programme (TISHIP) is a system of social security through which students ‘ health care in tertiary institutions is paid from funds pooled through student contributions. It is a system committed to ensuring that students from tertiary institutions have access to comprehensive healthcare services, thus supporting student health in order to create a healthy learning environment.

However, it requires awareness of students ‘ current practices and challenges in accessing care both during and out of session, as well as the potential of current tertiary health facilities to maximize access to quality health care.

Furthermore, Tertiary institutions are categorized as Universities, Colleges of Education, Polytechnics, Colleges of Agriculture, Monotechnics, Schools of Nursing, Midwifery, Health Technology, and other Specialized Institutions

ii. Community-Based Social Health Insurance Programmes

Community-based Public Health Insurance Program is a non-profit program designed for a single community of households/individuals or groups based on employment. It was formed on the basis of the principles of mutual assistance and the shared pooling of health risks in which participants were involved in managing this.

Membership

This will be voluntary and open to all (including retirees) residents (families) of participating communities / occupation-based groups. The registration unit is the family or individual members. In order to achieve a sufficient pool of funds to ensure financial viability and address the problem of adverse selection, communities / occupation-based groups will have at least 50 percent (or at least 1000 participants) of members willing to participate.

Registration Procedure

Registration of enrollees shall be by technical facilitators or BOTs. Each program shall have a clearly defined procedure for registering enrollees as well as a form of identification (such as membership card) to assist in the identification of scheme members

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3. Vulnerable Group

Vulnerable Group Social Health Insurance Programmes are designed to provide health care services to persons who due to their physical status (including age) cannot engage in any meaningful economic activity. However, contributions for this group is mostly done by the Federal, State, and Local Government and None Governmental Organizations (NGOs)

They include the following:

i. Physically Challenged Persons Social Health Insurance Programme(PCPSHIP)

Physically Challenged Persons Social Health Insurance Programme(PCPSHIP):-It is a program designed to provide health care services to Physically/Mentally Challenged Persons who due to their physical status cannot engage in any meaningful economic activity.

ii. Prison Inmates Social Health Insurance Programme(PISHIP)

A program designed to provide health care services to inmates of Nigeria Prisons and offending minors in Borstal Homes, who by virtue of their restriction, cannot engage in any activity to earn income.

iii. Children Under Five (5) Social Health Insurance Programme
(CUFSHIP)

Children under Five Social Health Insurance Programme (CUFSHIP) is a program designed to cover the health needs of children under the age of five (5) years across the country, who are considered vulnerable.

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iv. Pregnant Women
v. Retirees
vi. Aged

Conclusion on all you need to know about Nigeria Health Insurance Scheme (NHIS)

To register NHIS online log on to this address: https://www.nhisonline.com.ng/Registration/MemberRegistration and fill in the required fields.

Please use a computer as some error has been shown by using phones. You can fill in your own form, however, and that of other people you want to register. Send the form and print it out afterward as well.

In addition, go to nhis.gov.ng and look for your nearest office. They have offices in all federation countries. They’ve got more than one Lagos office. Copy the address and choose the day you want to visit. Go with each person’s printed form, 4 passports, and the amount of #15,000. For you, they will finish the registration process. A list of hospitals near you will also be displayed to choose as your service providers.

If it’s a multi-specialist hospital, consider proximity, quality. That way, when the need arises, you won’t waste time and money on a referral.


Note, you must stay for one year with your designated health care provider. You may be looking for another service in certain cases, but the switch may not come easily or at all.

Please let us know in the comment section below what you thought about this subject. Thank you for stopping.

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