HMO moves to capture 190m Nigerians in health insurance scheme

Ultimate Health Management Services has said it is working to ensure that the over 190 million Nigerians, who lack access to health insurance scheme, are brought on board. 

Specifically, the health maintenance organisation (HMO) stated that it was working with the regulatory agency to define the available clusters in the formal and informal sectors of the economy with a view to capturing everyone.

This comes amid concerns that 26 years after the establishment of health insurance in the country, not more than 10 million Nigerians have any form of the scheme.

Recent data show that over 190 million Nigerians do not have health insurance.  Speaking in Abuja at the 13th Annual General Meeting (AGM) of Ultimate Health Management Services, the Managing Director, Lekan Ewenla, asserted that the HMO was poised on enrolling all Nigerians on the scheme. 

According to the World Health Organisation (WHO), Nigeria has the highest out-of-pocket expenditure on health in West Africa. 

Statistics from the global health body indicated that out-of-pocket health expenditures account for more than 70 per cent of overall health spending in Nigeria, and in 2020, the country’s out-of-pocket spending was 74.7 per cent. 

Last October, the Coordinating Minister of Health and Social Welfare, Prof. Ali Pate, had revealed that 90 per cent of Nigerians were not covered in the nation’s health insurance scheme. 

But Ewenla said his organisation was partnering with regulatory authorities to ensure that all clusters are sensitised and captured.  He explained: “For example, we are looking at the youths of this country that are over 40 million in tertiary institutions across the nation. They will be mandated through the regulatory institutions to comply.

“We are looking at the organised private sector. They have already complied, but not total. So, we are going to see those that are still on the fringes, to bring them on board.” 

Ewenla underscored the need for inflationary trends to be put into consideration for upward review of premiums for services not to be disrupted by hospitals. 

He emphasised that health insurance is volume-driven, with provision for basic healthcare services to be covered.  Ewenla added: “As we speak, there are two risk managers for Nigerians. The first risk manager is the primary provider at the primary level. Services that are primary services are meant to be managed at the primary level by risk managers.

“At commencement in 2005, it was determined to be N550 per person monthly, and the actuarial reports that were submitted to the regulator indicated that there should be an upward review to 65 per cent within 24 months.

“This was to take care of the inflationary trend, which was responsible for the upward review of N550 to N750 in 2014.” On her part, Chairman, Board of Directors, Angela Ajala, noted that the HMO went beyond the N750 million minimum requirement stipulated by the National Health Insurance Authority.  She said it is the first HMO in Nigeria to diversify into Britain and America. 

“Our major highlight is recapitalisation. We have recapitalised to N1 billion,” she stated, noting that the minimum from their regulatory agency is N750 million. 

“We are the first HMO that has diversified into the Britain and America, which means we are standing strong enough on our local leg here, expanding and looking at what our fellow Nigerians need in the Diaspora, especially as many of them have families back home,” she declared.