Health Management Organisations (HMOs) offer a wide range of products that individuals and households as well as businesses can buy to enjoy quality healthcare and most importantly avoid out-of-pocket expenses in the event of illness.
Amid the rising cost of living, there are individual and family bundles that enable them to have access to healthcare without having to pay from their pocket.
Harrison Okafor, a doctor and head of medical services at MetroHealth HMO, said that at a time like this, more than any other, Nigerians need to take up health insurance to protect themselves from the astronomically high cost of medical care.
“Whilst the HMOs can still leverage bulk purchases in negotiations and other means to get some of these drugs, the individual is much more exposed and would have to pay much more,” he said.
Okafor said many HMOs have various retail plans with flexible payments (such as Metro Flexi plan) that allow monthly payments to enable individuals to access quality healthcare even in these difficult times.
He said: “Living without health insurance exposes many Nigerians to poor and substandard treatment, protracted illness, and exposure to quacks, which can lead to untimely death.
“We also have other products such as Metromini plan, Metromidi plan, Metromaxi plan and MetroPPP plan, which is our top of the range plan, thus we have products for all price points to address the needs of all Nigerians with different purchasing powers.”
Gideon Anumba, a doctor and head of operations at Leadway Health Ltd, said the HMO, which is the health insurance business of the group, has a range of health insurance products targeted at both the formal and informal sectors.
They include Leadway Retail (Berry) Plans targeted at individuals/families who are aged 54 years or less.
According to him, there is a plan for companies employing less than 10 staff, Leadway SME and Corporate plans are for employers with 10 staff members or more, while the Leadway Senior Citizens plans are targeted at retirees and individuals aged 55 years and above.
Anumba said the company is leveraging technology to improve efficiencies, preventive healthcare initiatives and wellness activities to save costs and hence keep premiums affordable.
Abdul-Rasheed Akolade, assistant director of underwriting and marketing at Africa Re, said health insurance covering named illnesses, injuries, or conditions provide funds for the treatment or management of conditions that might otherwise destroy a person financially.
Akolade described critical illness insurance as a powerful tool for preserving and building wealth. “Covering named dreaded diseases, such as heart attack, stroke, cancer, coronary bypass, major organ transplants, or kidney failure, critical illness cover is effective in managing large, ongoing, and expensive treatments that most people would struggle to afford.”
Avon HMO said it has retail plans for individuals, families and a small group of 1-29 people.
According to the company, the plans ensure that individuals get prompt and easy access to quality health care. The retail plans for family (except Life Starter) cover a family of six, which includes the principal and spouse: age (18-60), and four dependents between the ages of (0- 17) years.
Some of the services it offers include general consultations, lab investigations, prescribed drugs and infusion, and plain X-rays.
Tope Adeniyi, CEO of AXA Mansard Health, said the company has created a range of products that Nigerians can take any time, “from primary healthcare products as low as N1,000, which can give Nigerians access to consultation, treatments, medication, and even admission, to products that afford customers benefits such as treatment of critical illnesses and medical evacuation in case of emergencies”.
“We have ensured that these products are tailored for individuals, families, and even small, medium, and large organisations. We assure you that whatever healthcare needs Nigerians may have, there is an AXA Mansard health product tailored to it at the most affordable premium and with the ease of technology,” he added.
Analysts at Coronation Insurance said even though Nigeria does not have any national health insurance programme, the private sector provides extremely competitive offerings.
“Should a single individual have a policy insuring a particular condition up to N10 million, and another separate policy ensuring the same condition up to N20 million, then that individual would be able to call up to N30 million worth of cover in the event of contracting the named condition.”
They said that since premiums can generally be paid monthly, bi-monthly, annually, or even in a once-off lump sum, flexibility combined with relatively low premiums makes insurance available to most.
It is advisable to purchase health insurance while young or still on an active job. “Not only does this help preserve and grow wealth throughout one’s life and ensure better lifestyle choices and health outcomes, but it also enlarges the pool of contributions, enabling the industry to extend cover to more Nigerians,” the analysts said.
“It is also important that Nigerians understand that they can purchase multiple health covers, provided they declare overlapping covers at purchase.”
Another advantage of health insurance, they argued, is its impact on improving health outcomes.
“Once people purchase a health insurance policy, they usually become more aware of the dietary and lifestyle practices that contribute to improved health and longevity, as healthier behaviour extends the value and impact of their health investment,” they said.
In some countries, insurance providers actively incentivise healthy lifestyle practices through premium rebates or rewards. Healthier client populations reduce the cost of insurance, lowering premiums for members and allowing health cover to be extended to wider populations.