Have you ever had someone pay for your meal, or cab fare, or simply perform one gesture or the other that saved you some money? Well, think of health insurance as that benevolent someone. And access to health care when needed, as the item of value. Except in this instance, you lent a hand first, and then got some help in your time of need.
What is Health Insurance?
Heath Insurance is simply health security. It’s a type of insurance plan that typically covers for medical, surgical, prescription drug and sometimes dental expenses. This usually works in either of two ways. It could either be in form of payment made directly to a health care provider, on behalf of the insured, or it could be reimbursement to the insured for expenses incurred in the course of treatment.
There are different types of health insurance:
- Health maintenance organizations (HMOs)
- Exclusive provider organizations (EPOs)
- Point-of-service (POS) plans.
- Preferred provider organizations (PPOs)
Health Maintenance Organizations (HMOs)
HMOs give you a listing of doctors, hospitals, and other health care professionals and facilities that you are required to choose from. For instance, if you live in Abuja, your HMO will provide a list of Hospitals/clinics within Abuja registered with them, where you can receive care. The one you choose will be your Primary Care provider (PCP) .
Exclusive provider organizations (EPOs)
EPOs offer you a network of providers listed with them. Here you may not be required to choose one Primary Care Provider (depending on the plan). For most EPOs, if you visit a provider or facility outside the plan’s local network, you will likely have to pay the full cost of services yourself.
Preferred provider organizations (PPOs)
PPOs typically offer you a large network of participating providers to choose from. You may also choose to see providers from outside of the plan’s network, but you will pay more out-of-pocket. Choosing a primary care provider (PCP) is not required with these types of health plans, and you can see specialists without a referral.
Point of service plan (POS)
This combines features of HMO and PPO plans. The network of providers to choose from is typically smaller than a PPO plan. And like HMOs, the costs for in-network care are typically lower. Here, in addition to your primary Care provider, you can also choose to see specialists that are in-network or out-of-network. If you see a doctor outside the plan’s network, your share of the costs will be higher and you’ll be responsible for filing any claims yourself.
HMOs in Nigeria
HMOs are usually more affordable and are more common. If you own a phone with internet access, chances are you have come across at least one HMO advertisement. Recently, there’ve been quite the rise in the number of options to choose from. All claiming to be the best, promising to cater for you the best, in your time of need. So the big question is, how do you know which to choose?
The answer to this is simply to determine what your health needs are. If you’re in good health and don’t visit a doctor often, health insurance plans with higher deductibles which usually have lower insurance premiums, would be the way to go. This is because it could help save you money. However, if you require or expect more than just preventive care, consider plans that have lower deductibles and coinsurance, for more predictable costs.
A health insurance deductible is a specified amount or limit you must pay first, before your insurance will begin paying your medical costs. A health insurance premium on the other hand, is the amount you pay each month to your insurance provider.
That being said, here’s a list of 16 HMO’s in Nigeria.
- Hygeia HMO
- Total Health Trust HMO
- Integrated Healthcare Limited
- Avon HMO
- AIICO Multi-Shield Nig.
- Princeton Health Limited.
- Defense Health Maintenance Ltd.
- Mediplan Healthcare Limited.
- Reliance HMO
- Clearline International Limited (HMO)
- Swift HMO
- Novo Health Africa HMO
- Pro-Health HMO
- Venus Medicare Ltd
- Metrohealth HMO
- Redcare HMO
Follow our blog for more updates. Got any questions? Our Doctors are more than glad to help provide the assistance you need with our telemedicine feature. Find out more here. We’re on the socials! Follow us on Instagram, Facebook and Twitter for more.
