How to Register HMO In Nigeria Easily (2023)
As a citizen of Nigeria, you should be interested in how to register HMO in Nigeria. Well, you could say to yourself that you don’t need one. But kindly wait before concluding.
First of all, you can never predict when you may need urgent medical attention, and at this point, an HMO would be your best bet.
HMOs have been effective over the years in providing quality attention to their clients because that is the reason why they are set up.
By the end of this article, you will be confident of the fact that you now know how to register HMO in Nigeria, the characteristics of a good HMO, and an insight into the best leading HMO in Nigeria.
What is HMO Insurance?
Before going into detail on how to register HMO in Nigeria, it will be of great benefit to you, to be briefed on what an HMO means.
An HMO simply means a health maintenance organization (HMO). The HMO got its name because it offered services aimed at maintaining the health of members.
It is a business that, in exchange for payment, acts as a point of contact between individuals, self-funded healthcare benefit plans, and other entities to provide or arrange managed care on behalf of healthcare providers (hospitals, physicians, etc.).
According to the Health Maintenance Organization Act of 1973, businesses with 25 or more employees are required to provide federally certified HMO options even if they already provide conventional healthcare options.
In contrast to traditional indemnity insurance, an HMO pays for services provided by medical providers who have contractually agreed to treat patients in accordance with the HMO’s rules and limitations in exchange for a consistent flow of patients. Regardless of whether a healthcare provider is contracted with an HMO, emergency care is covered.
How Does HMO Work In Nigeria?
This is a valid question to get an answer to. And this is because you wish to know how to register for HMO in Nigeria.
Why would you want to register for a program that you don’t understand how it works?
HMOs frequently require members to choose a primary care physician (PCP), a doctor who serves as a gatekeeper for direct access to medical services, though this is not always the case. General practitioners (GPs), paediatricians, family physicians, internists, or geriatricians are the most common types of PCPs.
Some HMOs pay gatekeeper PCPs set fees for each defined medical procedure they provide to insured patients (fee-for-service) and then capitate specialists (that is, pay a set fee for each insured person’s care, regardless of which medical procedures the specialist performs to achieve that care), while others use the opposite arrangement.
An HMO and a conventional indemnity plan are combined to create open-access and point-of-service (POS) products.
Prior to seeing a specialist, the member(s) is not required to go through a gatekeeper or get a referral. In that case, the traditional benefits are still applicable.
The HMO benefits are used if the member uses a gatekeeper. For specialized care, the beneficiary cost-sharing (co-payment or coinsurance, for example) could be higher. Utilization review is another method used by HMOs to manage care.
In other words, they keep an eye on doctors to see if they are providing their patients with more or fewer services than other medical professionals.
In order to prevent members from acquiring a preventable condition that would necessitate a lot of medical services, HMOs frequently offer preventive care for a lower copayment or for free.
Preventive services like immunizations, well-baby checkups, mammograms, and physicals were frequently excluded from indemnity plans when HMOs first emerged.
Other options for managing care include case management, in which patients with catastrophic cases are identified, and disease management, in which patients with specific chronic diseases like diabetes, asthma, or some types of cancer are identified.
In either scenario, the HMO becomes more involved in the patient’s care and assigns a case manager to the patient or group of patients to make sure that no two providers are providing care that is similar to each other and to make sure the patient is getting the right care so that the condition does not get worse beyond what can be helped.
Types of HMO
There are various types of HMOs throughout the world and in Nigeria. Before looking at how to register HMO in Nigeria, it will be in your best interest to see the types of HMOs practiced in Nigeria.
And they are:
Staff Model HMO
An HMO with a staff model directly employs medical professionals and frequently owns the medical facilities it uses. Staff model HMOs only treat their own members, but patients can receive referrals when they require a service that the internal providers cannot provide.
Group Model HMO
A group model HMO establishes contractual ties with one or more group medical practices that primarily serve its members.
The majority of group model HMOs also contract for hospital services, making up just under half of them.
Network Model HMO
A network model HMO and a group model HMO both contract with one or more group medical practices to provide medical services for their members.
They differ in that the majority of the patients seen by the medical practice groups that have agreements with group model HMOs are those group model HMO members.
On the other hand, medical practice groups that have agreements with network HMOs may give a sizeable portion of care to patients who are not network members.
The distinction between these two HMO varieties may not be obvious to a patient.
Independent Practice Association (IPA) HMO
An HMO with an independent practice association may enter into agreements to provide its members’ medical care with specific doctors or with a group that advocates for particular doctors.
In both situations, the medical professionals typically work alone and treat a large number of patients who are not IPA HMO subscribers.
Again, from the standpoint of the patient, the distinctions between an IPA HMO, a network model HMO, and a group model HMO might not be obvious.
Merits and Demerits of HMO
So many people tend to look into how to register HMO in Nigeria without first knowing the various advantages and disadvantages associated with it.
This article will show you not just how to register for HMO in Nigeria, but all the juicy details that you need to know too.
Advantages of HMOs
The first and most obvious benefit of joining an HMO is the affordable price. In comparison to conventional health insurance, you’ll pay fixed premiums on a monthly or annual basis.
Your co-pays are typically lower with these plans than with other plans, and they frequently have low or no deductibles. Your out-of-pocket costs will also be lower for your prescription. Additionally, for those with an HMO, billing is typically simpler.
You’ll probably also have to deal with the insurer directly, which is another very real possibility. You must decide who will be in charge of overseeing your treatment and care because you have a primary care physician. This professional will also advocate for services on your behalf. This includes providing you with recommendations for specialty services.
With an HMO, the standard of care is typically higher. The explanation is that patients are urged to get yearly checkups and seek treatment as soon as possible.
Disadvantages of HMOs
You have limitations on how you can use the plan if you pay for an HMO. You will need to choose a doctor who will be in charge of all of your medical requirements, including primary care and referrals. However, this physician must be a part of the network.
Therefore, even if there isn’t a contracted physician in your area, you are still liable for any expenses incurred if you visit a healthcare provider outside the network.
If you want your HMO to cover any visits from specialists, you’ll need referrals. Therefore, in order for the plan to cover your visit to a rheumatologist or dermatologist, your primary physician must refer you before you can make an appointment. If not, you’re responsible for the entire cost.
For some medical claims, such as emergencies, there are very specific requirements that you must meet. For instance, the criteria for what qualifies as an emergency are typically stringent. Your condition won’t be covered by the HMO plan if it doesn’t meet the requirements.
Patients cannot see specialists or other doctors without a referral from their PCP, except in cases of a medical emergency, and the gatekeeper cannot approve that referral unless it is required by the HMO rules.
Certain services, like outpatient mental health care, are constrained, and more expensive diagnoses or treatments might not be covered. Experimental therapies and elective services that are not medically necessary (such as elective plastic surgery) are almost never covered.
How To Register HMO In Nigeria Easily
Now, that you know every detail about HMO, you will get a simplified explanation of how to register HMO in Nigeria. Below is a laid-out, easy process you can follow to register HMO in Nigeria.
To register with any HMO in Nigeria, you have to first register with the National Health Insurance Scheme.
Most companies offer HMO plans for their employees. If you want insurance but are not an employee (or a student, for that matter), you can sign up as a voluntary contributor. For that, you will need to follow these steps: Locate a nearby health maintenance organization (HMO) that is participating and buy a voucher there.
Alternatively, you can skip this phase and continue using Remita. Go to www.nhisonline.com.ng and look for the “Voluntary Contributors” button in the top right corner. In order to register, click the link after pressing the button and then scroll down.
Fill out the form that appears in front of you, making sure to enter all the information accurately. Your state and LGA will be requested at the end of the application, which will automatically reduce the number of healthcare facilities from which you can choose. Choose the option that best suits your needs.
In the absence of any, try selecting different LGAs or states. At the very end, you will be asked to select your payment method. On the following page, you must enter the information from your voucher if you have one. If you select Remita, you will be directed to a website where you can finish making your payment.
Once your application is complete and the required fees have been paid, you should be accepted into the program. That is how easy it is to register HMO In Nigeria.
Which HMO Insurance is Best in Nigeria?
Now that you know how to register HMO in Nigeria, you should seek the best HMO that will serve your needs.
There are so many HMO options in Nigeria, but the one that stands out is Serene Healthcare
It is a healthcare organization that provides personalized healthcare to its clientele, thereby giving them a good return for their money.
For a health maintenance organization to be considered the best, it needs to ensure that speed, empathy, reliability, excellence, integrity, teamwork, novation (innovation),
Below are some criteria that make them stand out. And they are:
To enroll in an HMO, financing will be required. And this money will be used to provide the services required by various individuals.
At serene health, the fee for HMO service is very affordable, and to top it all, they have the most affordable premium service too.
Free Monthly Medical Check-Ups
Serene Health Care offers free medical examinations to its patients every three months. These examinations include BML, blood pressure checks, and blood sugar checks.
This is a good offer, as many people tend to not take medical checkups seriously. As much as your reason is understandable, serene health has taken it upon herself to be there for you when it matters.
Unlike most HMOs, you will need to visit their network for something as trivial as first aid treatment.
And this makes Serene Health Care stand out. During an injury or minor accident, first aid should be administered before anything else.
With this and you in mind, serene health care took it upon herself to provide you with your own special first aid box. Isn’t that great?
No Enrollee List
Being an HMO that values the time of her clients, serene health eliminates the need for you to spend valuable time waiting to see a doctor,
With their strategic network, doctors will attend to you in the blink of an eye, and in no time, you will be back at your location.
Preventive Health Awareness Forums
A popular maxim says, “Health is wealth.” And this is not overlooked in serene health. At serene health, preventive health awareness campaigns are carried out to educate employees about the likelihood of developing a disease in the future, enabling early diagnosis and treatment to boost workplace productivity.
FAQs About How To Register HMO In Nigeria
What is better: HMO or PPO?
Typically, HMO plans have lower monthly premiums. Furthermore, less cash outlay is to be anticipated. PPOs typically charge higher monthly premiums in exchange for the freedom to choose from a wide range of providers, both in and out of the network, without a prescription. A PPO plan may also have more expensive out-of-pocket medical expenses.
What is the difference between an HMO and health insurance?
An HMO’s coverage is typically quite limited and less expensive for the parties who are insured. The costs of traditional health insurance, on the other hand, are higher in terms of premiums, deductibles, and co-pays.
But health insurance plans are much more flexible. A primary care physician is not necessary for those with health insurance to provide treatment recommendations. Some of the expenses for using out-of-network providers are also covered by health insurance.
Is it difficult to register HMO in Nigeria?
Although it is time-consuming, but to register HMO in Nigeria is not really difficult.
If I register HMO in Nigeria, is there any benefit?
Yes, there are numerous attached to the fact that you register HMO in Nigeria.
Why should I register HMO in Nigeria?
This is because when u register HMO in Nigeria, you reap all the benefits attached to it unapologetically and your business or HMO company will be recognized as legitimate.
Conclusion On How To Register HMO In Nigeria
Now that you know how to register HMO in Nigeria, take advantage of it and include your friends and family too.
The benefits that are attached to HMO are so mouth-watering that you won’t be able to resist. And you can make use of serene health, as they offer top-notch services to their clientele.