Medical Insurance – How It Works In Nigeria

Medical insurance is a critical yet complex aspect of the market, particularly in countries like Nigeria. Essentially, the average citizen is unconcerned about protecting oneself and instead focuses on valuable assets. However, life remains our most valuable asset, and thus the medical part of insurance. The federal government’s recent decision to make health insurance mandatory has helped to broaden its reach across the country. As a citizen, it is crucial to understand how medical insurance works in Nigeria.

What is medical insurance?

Medical insurance merely protects or insures against certain medical expenses. Furthermore, the coverage is usually limited depending on the specifics of the plan. However, the average one mostly covers specialist medical treatments, while others cover medical procedures. Medical insurance is typically managed by a health maintenance organization (HMO), which settles bills directly with hospitals or reimburses the insured if they pay out of pocket.

How does a medical insurance work?

It has a simple functioning procedure, instance, prerequisites for obtaining health insurance. It entails an individual acquiring an insurance plan that provides certain medical coverage, or more, depending on the policy. It usually covers certain diseases, hospitalization treatment, accidents, and other medical expenses. However, this may vary based on the policy’s coverage. Also, usually comes with a predetermined assured sum.

They create a plan or policy based on the following information: the insured’s age, gender, sum insured, geographic location, and anticipated term of the plan. Furthermore, HMOs process medical insurance in two forms: cashless care and reimbursement. Furthermore, you can buy an individual plan or a family edition.

What are the benefits of medical insurance?

It comes with different benefits, which include the following:

• It provides coverage against pre specified medical expenses
• Coverage against critical illnesses
• Cashless claim benefit that eases you off out-of-pocket payment
• It gives additional protection beyond the basic group plan purchased by most employer

What does it cover?

Generally, medical insurance mostly covers the following:

• Other exceptions and peculiar treatments as stated by the policy
• Cosmetic procedures
• Fertility treatment
• Certain expensive medical procedures

It usually does not cover the following but could, depending on your policy:

• Regular hospital visits
• Drug prescription
• Wellness and care

What is the difference between medical insurance and health insurance?

The main distinction between the two is that medical insurance provides coverage for specific ailments and accidents for a set period of time. On the other side, health insurance provides more complete coverage for hospital charges. Furthermore, medical insurance excludes essential conditions and provides little coverage flexibility. Furthermore, health insurance provides these benefits while also allowing you to lower the length of your policy and premiums over time.

Conclusion

Medical insurance is the least well-known segment of Nigeria’s insurance business. It covers particular pre-defined procedures and is more specialized than standard health insurance. Furthermore, getting medical insurance is your greatest protection against dealing with expenditures that may occur from emergency specialized treatments.