Best Health Insurance (HMO) Plans in Nigeria: What They Cost and Cover (2026)

A standard individual HMO plan in Nigeria costs anywhere from about ₦118,000 a year for basic cover at local hospitals to over ₦1,000,000 a year for a plan that includes top private hospitals and bigger limits, based on Leadway Health's published retail price list. If you're self-employed or work informally, NHIA's own GIFSHIP scheme is far cheaper: ₦22,000 per person a year plus a one-off ₦1,500 ID card fee, paid through Remita, according to NHIA's GIFSHIP page. Figures checked October 2026.

Quick facts: HMO and NHIA cover in Nigeria

Is health insurance actually compulsory in Nigeria?

Yes, on paper. Section 14(1) of the National Health Insurance Authority Act 2022 says all residents of Nigeria must have health insurance, and section 14(2) names who that covers: employers and employees in the public and private sectors with five or more staff, informal sector workers, and everyone else living in the country, as a law firm's reading of the Act confirms.

In practice, enforcement is patchy outside government and large private employers. If you work for a company with five or more staff, ask HR whether you're enrolled in a Health Maintenance Organisation (HMO) plan already — many employers already deduct for it. If you're self-employed, a freelancer or you run a small business, the obligation falls on you to sort your own cover, usually through GIFSHIP or a private HMO plan.

What are your options?

There are three routes into cover, and which one applies depends on how you work:

1. Formal sector cover — if you're employed by a company with 5+ staff, your employer should register you and your contribution comes off your salary. Check your payslip; if health insurance isn't on it, raise it with HR.
2. GIFSHIP (Group, Individual and Family Social Health Insurance Programme) — NHIA's own scheme for people outside formal employment: the self-employed, informal traders, students, associations and cooperatives. You need a National Identification Number to enrol — if you don't have one yet, see how much NIN registration actually costs in Nigeria (registration itself is free).
3. A private HMO plan — bought directly from an HMO such as Leadway Health, Reliance Health, AXA Mansard, Avon Healthcare or Hygeia HMO. These give you more choice of hospital network and benefit limits than GIFSHIP, at a higher price. Browse our other insurance guides if you're also weighing this against life or motor cover.

How much does a private HMO plan actually cost?

Prices vary a lot by HMO and by what you're buying, and most HMOs don't publish full price lists online, which makes comparing them harder than it should be. Leadway Health does publish its retail (individual) tiers, and they're a useful real-world example of what you're paying for as the price climbs:

Source: Leadway Health's retail plan page, checked October 2026. Maternity isn't covered in your first policy year on any of these tiers, and optical cover only kicks in after the first three months — a common catch across HMOs, not just Leadway's.

Other HMOs price similarly for similar cover, but ask for a written quote and benefit schedule before paying anyone, since published online prices (where they exist at all) change often and some HMO marketing sites quote different figures for the same plan in different places. If you're salaried and want to see what's already coming off your pay before you add a health plan on top, run your numbers through our Nigeria PAYE calculator.

What does GIFSHIP cover, and who's it for?

GIFSHIP is NHIA's scheme for people who aren't in formal employment — the self-employed, informal traders and artisans, students, and members of associations or cooperatives that enrol as a group. At ₦22,000 per person a year, it's the cheapest route to cover that's still backed by the national scheme rather than a private HMO, per NHIA's own GIFSHIP page.

What you get, according to NHIA's FAQ:

• Cashless treatment at NHIA-accredited facilities only — treatment outside the accredited network generally isn't covered.
• A contributor's cover extends to a spouse and up to four biological children under 18. Extra dependents beyond that can be added, and a 10% co-payment applies to drugs.
• Kidney dialysis is covered, but capped at six sessions a year.
• Illnesses linked to HIV/AIDS are covered; the antiretroviral drugs themselves are handled separately through the National Agency for the Control of AIDS (NACA), not NHIA.

NHIA's enrolment had reached roughly 23 million people by late September 2026, so the scheme is genuinely active — but confirm which facilities near you are accredited before you rely on it, since not every hospital or clinic accepts NHIA cover.

What HMO plans usually don't cover

Every plan has an exclusion list, and it's worth reading before you pay, not after you get a bill. Reliance Health's published exclusions for its personal plans are a useful checklist of what to ask about with any HMO, from Reliance's own exclusions page:

• Pre-existing conditions — an illness you already had, or were being treated for, before your cover started. Chronic conditions like hypertension and diabetes are often excluded unless you've paid for a specific pre-existing condition extension.
• Fertility treatment — consultations, investigations and procedures related to infertility.
• Cosmetic or plastic surgery, and treatment linked to intentional injury, substance abuse or high-risk sports.
• Organ transplants, and some advanced imaging (CT, MRI) on lower-tier plans — these are usually only included once you move up a plan tier.
• Newborn care for a baby not already added to the plan, including incubator and neonatal ICU care.

Exclusions differ by HMO and by plan tier, so this list is a starting point, not a universal one. Always ask for the written benefit limits and exclusion schedule, not just a sales pitch, before you pay for any plan.

What to watch out for

• Don't pay an agent you can't verify. Confirm an HMO is NHIA-accredited and pay the HMO directly, not a middleman, before handing over money.
• Check the hospital list, not just the HMO's name. A plan is only as good as the facilities near you that actually accept it — ask for the list of hospitals in your area before you buy.
• Ask how maternity and dental are capped. These are usually fixed amounts per year (not "fully covered"), and maternity typically isn't paid out in your first year on the plan.
• Get the exclusion list in writing. Verbal assurances from a sales agent aren't the same as what's in your policy document.
• If you run a business with 5+ staff, you're expected to register and contribute for your employees under the NHIA Act — worth sorting alongside other compliance once you've registered your business with CAC.

Frequently asked questions

How much does health insurance cost in Nigeria?

It depends on the route. NHIA's GIFSHIP scheme for the self-employed and informal sector costs ₦22,000 per person a year plus a ₦1,500 ID card fee. Private HMO retail plans cost more — Leadway Health's individual tiers run from about ₦118,122 to ₦1,002,456 a year, depending on the hospital network and benefit limits, as of October 2026.

Is health insurance mandatory in Nigeria?

Yes, under section 14 of the NHIA Act 2022, all residents are required to have health insurance, and employers with five or more staff must register and contribute for their employees. Enforcement is still inconsistent outside formal employment, but the legal obligation applies to everyone.

What's the cheapest way to get health insurance in Nigeria if I'm self-employed?

NHIA's GIFSHIP scheme is the cheapest route backed by the national scheme, at ₦22,000 per person a year. You'll need a National Identification Number to enrol, and you pay through Remita.

Does NHIA cover dialysis and HIV treatment?

Dialysis is covered but capped at six sessions a year. HIV/AIDS-related illnesses are covered under NHIA, but antiretroviral drugs are supplied separately through the National Agency for the Control of AIDS (NACA), not through your HMO or NHIA cover.

What does an HMO plan not cover?

Common exclusions across HMOs include pre-existing conditions you had before your cover started, fertility treatment, cosmetic surgery, organ transplants, and newborn care for a baby not yet added to the plan. Exact exclusions vary by HMO and plan tier, so always check the written policy document.

Can my health insurance cover my spouse and children?

Under NHIA cover, a contributor's registration typically extends to a spouse and up to four biological children under 18, with extra dependents addable on top. Private HMO family plans work similarly but set their own limits — check with the specific HMO.