Healthcare is expensive all over the world. The challenge is even more profound in Nigeria where government funding of healthcare is grossly inadequate. It is against this backdrop that sadly 85% of Nigerians continue to pay for healthcare out of pocket.
With only 5% of the population having health insurance, our editorial team sought to find out how more Nigerians can have access to quality healthcare through affordable health insurance.
In this interview with Mr Banji Omojola, Head of Corporate Business at Redcare HMO, one of Nigeria’s largest Health Maintenance Organisations, we sought answers to questions the average man on the street typically asks about how health insurance works and how they can benefit from it without breaking the bank. Enjoy reading!
Q: Good day Mr Banji, in lay man terms, what is health insurance and how does it work?
A. Good day moderator. There are many definitions but in simple terms, health insurance is like employing a security guard to protect your property. With health insurance, you are paying the insurance provider called HMO to ‘protect’ your most important asset – your health by ensuring you have access to healthcare whenever you need it without having to worry about where the money will come from.
Health coverage otherwise called insurance means that all people have access to the health services they need, when and where they need them, without financial hardship. It includes the full range of essential health services from health promotion to prevention, treatment, rehabilitation and palliative care.
That said, health insurance is an insurance plan subscribed to by many healthy people to provide access to care for a few that might need to receive care in the hospital during the course of any insurance year.
Q: Why is health insurance important?
A. Health insurance is very important because it guarantees the income of the subscriber (i.e. the person insured otherwise called the enrollee). The health insurance plan takes care of the payments at the hospital which he/ she would have made out of pocket or from his/her earnings. So, it is an earnings saver! For instance, it is possible to pay only N3,000 per month for a health insurance plan that gives you access to healthcare services that could otherwise cost you up to N1.2m in a year.
Aside the cost-saving, the rest of mind that comes with having a health insurance is immeasurable. You are not worried about unexpected medical bills or reluctant to go the hospital because your medical bill will be paid for by your insurance either in full or in part. As such, you don’t have to start appealing to people to come to your aid particularly when they too may have their own financial challenges.
Q: I heard that health insurance is only for civil servants and people that work in big companies like banks and oil companies, is that not the case?
A. That is not the case. Health insurance is available to all. The recent signing into law the National Health Insurance Authority Act by the Nigerian President, His Excellency President Muhammadu Buhari now makes health insurance compulsory for all Nigerians including the vulnerable.
Q: I have faith in God to protect me and my family. I believe that sickness is not my portion and I have divine insurance. Why should I take up health insurance? Does that not amount to lack of faith in God?
A. The holy books which is the spoken word of God says; “Wisdom is the principal thing; therefore get wisdom: and with all thy getting get understanding. Exalt her, and she shall promote thee: she shall bring thee to honour, when thou dost embrace her” Proverbs 4:7-8.
Preparing for an eventuality is a characteristic of wisdom. When we plan easy access to care for our loved ones in the event that it occurs, we have fulfilled wisdom as beseeched in my quotation above.
Q: Some of my Moslem friends believe that health insurance is halal or haram, what do you say?
A. Health insurance in the Islamic way is available in the market. This is because the Almighty Allah wants us to prosper even in our health. Even the holy Prophet (SAW) said; “The strong believer is better than the weak believer” (Sahib Muslim), so making it possible for a Muslim to access care to be strong both physically and without the burden of out of pocket payment is noble.
Q: I have been suffering from high blood pressure and diabetes for the past 13 years, am I still eligible for health insurance?
A. Yes you are eligible. All you need to do is approach an HMO like Redcare and disclose these conditions in the medical disclosure form you will be asked to complete and the rest is history.
Q: Ok I get it now, so what benefits will I get from health insurance? What exactly will it cover?
A. Well, there are various benefits that can accrue to you as a health insurance subscriber. The plan you have subscribed to determines your level of benefits. It means that depending on your insurance plan, health insurance will pay for your hospital bills for healthcare services you receive like consultation with a doctor, hospital admission, diagnostic tests, surgery, emergency evacuation, immunization, pregnancy care, telemedicine and so much more!
Generally speaking, the benefits range from primary, secondary and tertiary care that is available for the enjoyment of the subscriber.
Q: How do I know the type of health insurance cover that is best for me and my family?
A. This is a fantastic question! All you need is to reach out to a credible subscriber-focused and highly professional HMO like Redcare HMO and you would be properly advised on the right plan for you and your family.
Q: I am a business owner with 5 staff working for me. Why is health insurance important for them?
A. Any employer that treat their staff well will see their staff treat the customers well. In addition to that, productivity of such employees will usually remain optimum and the business benefits in return. So I will implore more employers to embrace the provision of health insurance as a benefit to their employees.
Q: What do I need to get health insurance for instance do I need to do any medical test first?
A. Well, apart from the premium, you will be required to avail the HMO with a couple of information including your medical history and you would be required to declare any current media condition in demonstration utmost good faith. That is all that is required for you.
Q: Can I enroll my 73-year old mother on a health insurance or is she considered to be too old?
A. Yes. It is possible to do so at Redcare HMO. We have a seniors plan available for that category of customers. Although many other HMOs don’t offer such plans.
Q: I live in Europe but visit Nigeria once or twice a year. Is it really worth taking a health insurance in Nigeria?
A. Health insurance with a world-wide coverage is available for your subscription. The plan would cover you any where you are although with a few exceptions. Kindly reach out to Redcare HMO to advise on the right plan for you
Q: Can I use my health insurance for travel insurance to any country?
A. You would require a travel insurance extension/layer on your local plan for you to be able to travel to any other country. Your local plan is geographically limited
Q: My wife is pregnant. Can health insurance cover her pregnancy?
A. Yes. Health insurance offers maternity benefits including for natural birth and caesarian section.
Q: Does health insurance cover things like dental care, optical care, Covid-19 illness etc?
A. Yes. Optical (eye) and dental care are covered by health insurance plans. COVID-19 treatment are currently not covered. However, HMOs like Redcare offers COVID -19 test as part of offerings to our enrollees.
Q: If I take up health insurance today, how long will I need to wait before I can start enjoying the benefits?
A. Immediately you complete your enrollment, you can proceed to access care with Redcare HMO.
Q: Can I cancel my health insurance at any time I want?
A. Yes. You can cancel your plan at anytime and you will be refunded the unutilized premium provided you have not utilized the major benefits on the plan.
Q: Does health insurance cover IVF?
A. IVF is an Artificial Reproductive Technology (ART). The basic health Insurance plan does not cover IVF. However, some private clients do request for up to a maximum of two circles with the prescribed medications on their plan and are ready to pay the premium.
Q: Can health insurance pay for my gym membership?
A. Gym membership is now being offered as added benefit s to subscribers by HMOs. Redcare offers this benefit as healthy life style reward.
Q: When will I be able to claim my health insurance? Is it anytime I feel unwell like when I have malaria fever?
A. Yes. Whenever you feel unwell visit your chosen provider to access care.
Q: What does health insurance not pay for?
A. Health insurance does not pay for excluded benefits, illnesses or services. Clearly it is tilted towards medically necessary cases.
Q: Is there any health insurance that pays for breast enlargement or butt implant?
A. Those are cosmetic surgeries that are not medically necessary but for enhancement purposes. Health insurance would not cover those.
Q: I now understand health insurance better, if I have further questions how can I find the answers I need?
A. We are here for you 24/7. You can give us a call or send us a WhatsApp chat via our marketing partners MyMedicalBank on +234 (0) 802 759 0165 or send us an email via [email protected].
Q: I want to get started. How do I enroll my family or my company on a suitable health insurance plan?
A. Our onboarding process is very simple and straightforward. For any of our Redcare HMO’s private health plans (for individuals and families):
- Click here to enroll on our Start R Plan for N35,999 per year
- Click here to enroll on our R-Care Plan for N40,999 per year
- Click here to enroll on our R-Care Plus Plan for 65,000 per year
- Click here to enroll on our R-Care Xtra Plan for N129,999 per year
To get a quote for our corporate health plans (for corporate organisations and their staff): Please call Redcare HMO on 07007332273 or send a mail to [email protected]
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MyMedicalBank is Nigeria’s #1 digital platform that connects consumers with healthcare providers, health information and their health records from their smartphones from any location. For enquiries, go to www.mymedicalbank.com/contact.