The healthcare industry in Nigeria has witnessed significant growth in recent years with the emergence of Health Maintenance Organizations (HMOs). HMOs have made access to quality healthcare more affordable and accessible to many Nigerians. There are currently over 60 HMOs operating in Nigeria, making it difficult to determine the best. However, based on factors such as range of services, hospital networks, online presence, membership base, and customer reviews, here are the top 10 best HMOs in Nigeria.
Top 10 Best HMO In Nigeria 2023
Avon Healthcare Limited
Avon Healthcare Limited is one of the largest and fast-growing HMOs in Nigeria with over 600,000 enrollees. They offer a wide range of health insurance plans including individual, family, group and corporate plans. They have an extensive hospital network with over 1000 hospitals across Nigeria where their members can access care. They also have an online portal where enrollees can access their health plans and other details.
Hygeia HMO
Hygeia HMO is a leading HMO in Nigeria providing health insurance coverage to over 500,000 people. They offer retail plans for individuals and families as well as corporate plans. Hygeia has a robust hospital network spread across all states in Nigeria including private, public, faith-based and primary healthcare centers. They are very reputable for prompt claims payment and quality customer service.
Healthcare International
Healthcare International Limited (HCI) commenced operations in 1999 and has grown to become one of the largest HMOs in the country serving over 400,000 people. They offer a wide range of health plans including individual, family, group and corporate health plans. HCI has a hospital network of over 900 hospitals, clinics and diagnostic centers across all states in Nigeria giving their members access to quality care whenever needed. They are also very efficient with claims management and payment.
Ensure HMO
Ensure HMO is a fast-growing HMO that offers retail and corporate health insurance plans to over 300,000 people across Nigeria. Their retail plans include individual, couples, and family health plans. They also design customized corporate health plans for organizations. Ensure HMO has partnered with high-quality private hospitals across all geopolitical zones in Nigeria. They are reputable for providing top-notch customer service and prompt claims settlement.
Oceanic Health Management
Oceanic Health Management Limited commenced operations in 1997 and has since grown to become one of the most reputable HMOs in Nigeria serving over 250,000 people. They offer a variety of health insurance plans such as individual, family, group and corporate health plans. Their plans provide access to a wide network of over 500 hospitals across Nigeria. Oceanic Health is known for efficient operations, timely customer support and prompt claims payment.
Universal Care HMO
Universal Care HMO is one of the fast-growing HMOs in Nigeria providing health insurance services to over 200,000 individuals and corporate organizations. They offer retail plans such as couples, family and individual health plans. They also design customized corporate health insurance plans for organizations. Universal Care has partnered with a wide network of reputable private hospitals across Nigeria. They are known for their affordable health plans, quality service delivery and prompt claims settlement.
Hallmark HMO
Hallmark HMO is an innovative HMO that leverages technology to make access to quality healthcare easy and affordable. They offer a variety of health insurance plans including individual plans, group plans and corporate plans. Hallmark HMO has a network of over 300 reputable private hospitals across Nigeria where their members can access care. They have an online portal where enrollees can view details of their health plans and access other services. Hallmark HMO is reputable for seamless operations, affordable rates and quick claims processing.
Greenbay HMO
Greenbay HMO focuses on providing personal, group and corporate health insurance plans. They have an online platform where enrollees can access information on their health insurance plans. Their health plans provide access to quality care from a wide network of private hospitals. Although they have been in operations for a few years, Greenbay HMO is fast gaining popularity due to their affordable rates, efficient operations and prompt customer support.
Metrohealth HMO
Metrohealth HMO offers individual, couples, family, business and organizational health insurance plans. They have partnered with reputable private hospitals across Nigeria to provide quality care to their members. Metrohealth HMO has been in operations for over 10 years serving citizens across different states in Nigeria. They are known for their affordable health plans and quality service delivery.
Total Health Trust
Total Health Trust is the largest HMO in Nigeria serving over 300,000 enrollees including individuals and corporate organizations. They have been in operations since 1998 and offer a wide range of health insurance plans such as individual, family and corporate plans. Total Health Trust has an extensive hospital network covering over 500 private hospitals across Nigeria. They are reputable for their large membership base, affordable rates, and prompt claims settlement.
Frequently Asked Questions
What is an HMO?
An HMO is a Health Maintenance Organization. It is a health insurance company that provides health insurance plans to individuals and organizations.
What are the types of health insurance plans offered by HMOs?
HMOs offer retail plans for individuals and families such as individual, couples and family health plans. They also offer group plans for small businesses and corporate health plans for large companies.
What hospitals can I access under an HMO plan?
Most HMOs have a large network of partner hospitals across Nigeria comprising both private and public hospitals. The specific hospitals you can access depend on the HMO and health plan you subscribe to. You will be given a list of partner hospitals available under your health plan.
Do HMOs cover pre-existing medical conditions?
Most HMOs in Nigeria cover pre-existing medical conditions but with a waiting period, usually 2-3 years before you can make claims relating to such conditions under the health plan. Some HMOs waive the waiting period for certain pre-existing conditions.
How do I make a claim under an HMO?
To make a claim under an HMO, you visit any of the partner hospitals available under your health plan for treatment. The hospital will bill the HMO directly for the services provided. Some HMOs may require you to pay upfront and request for reimbursement. The specific claims process depends on the HMO.
How much does HMO health insurance cost in Nigeria?
The cost of HMO plans in Nigeria varies depending on the HMO, type of plan and coverage level. On average, you can expect to pay between ₦5,000 to ₦50,000 per month for a retail plan covering a family of four. Corporate plans typically cost ₦3,000 to ₦15,000 per employee per month.
Can I subscribe to more than one HMO at a time?
It is not advisable to subscribe to multiple HMOs at the same time for several reasons. Your health insurance coverage may overlap leading to unnecessary expenses. It can also be administratively cumbersome managing multiple health plans. Most HMOs explicitly prohibit subscribing to competing health insurance plans.
Can I subscribe for health insurance if I have a pre-existing medical condition?
Yes, you can subscribe for health insurance even if you have a pre-existing medical condition. However, most HMOs will stipulate a waiting period, usually 2-3 years before you can make claims relating to such pre-existing conditions. Some HMOs may waive or reduce the waiting period for certain conditions. The waiting period will be stated in your health plan terms and conditions.
What is the waiting period for maternity or child delivery claims under an HMO?
The waiting period for maternity or child delivery claims under most HMOs in Nigeria is usually 12 months. This means you must have subscribed to the health plan for at least 12 months continuously before you can make claims for child delivery or any maternity related conditions and procedures.
How can I renew my health insurance plan with an HMO?
To renew your health insurance plan, you need to pay the renewal premium within 30 days of the expiry date of your existing plan. The HMO will send you a renewal notice indicating the new premium amount and any changes to the health plan terms and conditions, hospital network etc. You then make payment for continued access to coverage. Failure to pay within the stipulated time will result in termination of the health plan.
Wrapping Up
While there are many HMOs operating in Nigeria, the ones listed in this article are the leading organizations based on membership coverage, service offerings, online presence, hospital networks, and customer reviews. They make access to quality healthcare easy through their affordable and comprehensive health plans.