Health Insurance in Nigeria: HMOs & the NHIA Explained (2026)

One serious illness can wipe out years of savings — which is exactly what health insurance protects against. Under Nigeria's 2022 law it's now mandatory, but most people still don't understand how it works. Here's the plain-English version.

It's the law now. The National Health Insurance Authority (NHIA) Act 2022 makes health insurance compulsory for every Nigerian and legal resident — and businesses with five or more staff must enrol their employees.

What changed: from NHIS to NHIA

The old NHIS (1999) covered less than 10% of Nigerians. The NHIA Act 2022 replaced it, turned the scheme into an Authority, and made coverage mandatory — aiming for universal health coverage. Enrolment has been climbing (past 22 million Nigerians in 2026) as the mandate rolls out through federal and state schemes.

How it works — the role of HMOs

You access care through a Health Maintenance Organisation (HMO) — the company that administers your plan and connects you to a network of hospitals and clinics. You (or your employer) pay a premium; when you need care, you go to a hospital on your HMO's list and the plan covers the agreed treatments, so you're not paying large bills out of pocket. Under the NHIA reforms, HMOs administer plans while contributions are pooled through the state schemes and NHIA.

What it costs

• Formal employment (organised private sector): the standard structure is employer 10% + employee 5% = 15% of basic salary, and your cover extends to one spouse and up to four children under 18.
• Individuals / families / SMEs: you can buy a plan directly from an HMO — premiums vary widely by the plan's hospital network and what it covers (from basic to premium/international). Compare the network, exclusions and limits, not just the price.
• Low-income and informal groups: state social health insurance schemes and vulnerable-group programmes aim to widen access.

How to choose a plan

1. Check the hospital network — are good hospitals near you on the list?
2. Read the coverage and exclusions — what's included (consultations, drugs, surgery, maternity, chronic care) and what isn't.
3. Understand the limits — annual caps, waiting periods, and any co-payments.
4. Confirm the HMO is NHIA-accredited — only use registered providers.

Compare the leading NHIA-accredited HMOs — network, plans and claims reputation — on our health insurance comparison. Budget the premium into your monthly plan, and keep an emergency fund for what insurance doesn't cover. It sits alongside your other statutory deductions — see understanding your payslip.

Frequently asked questions

Is health insurance compulsory in Nigeria? Yes — under the NHIA Act 2022 it's mandatory for every Nigerian and legal resident, and employers with five or more staff must enrol them.

How much does health insurance cost? In formal employment, 15% of basic salary (10% employer + 5% you), covering a spouse and up to four children. Individual/family plans vary by HMO and network.

What's an HMO? The company that administers your health plan and links you to a network of hospitals. You pay a premium; it covers agreed care at listed hospitals.

Educational information, not financial or medical advice. NHIA rules and HMO plan terms vary and change — confirm current details with the NHIA or an accredited HMO before enrolling.