Paying medical bills can be financially draining, especially in developing countries like Nigeria. However, having a system where the financial burdens associated with health is partially or entirely taken care of beams hope for a future that is financially secured for employees, individuals, and families.
Health Maintenance Organisations is that system created to ease the financial burdens that accompanies health challenges. HMO insurance in Nigeria was established in Nigeria to make healthcare affordable to all.
It acts as an intermediary between healthcare providers and patients so as to afford them quality care.
HMO insurance in Nigeria has grown as an industry with significant strides with major players like Hygeia HMO; Total Health Trust; AIICO HMO; Premium Health HMO; Avon HMO, and so on.
The plans provided by these organisations cater to senior citizens, as well as individuals and families. They partner with different hospitals and clinics to ensure a wide coverage.
Though there are challenges associated with HMOs in Nigeria, such as limited coverage for chronic conditions, restricted provider networks, high premium costs, nonetheless, many have benefitted from the opportunity it provides to reduce financial burdens.
Like other countries with health care plans regulated by the government or health ministry, HMO insurance in Nigeria through the National Health Insurance Scheme and National Insurance Commission is regulated by the federal government.
The frameworks set by the regulatory bodies ensure compliance with standards, while protecting the interests of enrollees.
Key Features of HMO Insurance in Nigeria
The features of HMO in Nigeria are listed as:
Comprehensive coverage (outpatient, inpatient, surgical, and so on.)
Network of healthcare providers
Prepaid subscription
Administrative efficiency
Limited out-of-pocket expenses
Types of HMO plans in Nigeria
These are the types of HMO plans existing in Nigeria:
- Student plans
- Individual/Family plans
- Group/Corporate plans
- Senior citizen plans
Whether it is a student, individual, family, group, or senior citizen plan, their effectiveness and adherence to relevant laws are regulated by the National Health Insurance Scheme, Federal Ministry of Health, and National Insurance Commission.
What is The Limit Covered in HMO?
Limits covered in HMO always vary. And why is this? It is because the type of plan and provider chosen will determine the limits, just like other insurance coverages.
Take, for instance, Reliance HMO provides different plans with coverages that vary, such as: the Red Beryl Individual Plan health coverage which gives to over 700 hospitals, and coverage for selected surgeries.
Pre-existing Condition Plan also covers severe conditions with a monthly premium, while the Alexandrite Individual Plan covers about 14 surgeries giving access to over 800 hospitals across the country.
Limits Covered in other HMO providers vary, which is why you should check with your HMO provider to determine the plans that are most suitable.
Health Maintenance Organisations plans cover a range of health care services identified as: Dental care Admissions Prescription of medicines and drugs; Optical care; Ambulance service; Antenatal and childbirth; Scans; Minor surgeries, etc.
Now that you know what HMO means, the HMO insurance in Nigeria and the limits HMO covers, what are your thoughts?
Share them with us in the comment box and other posts you would like to see posted here.
