Is NHIS in Nigeria Worth It for Families? Full Guide for 2025

Healthcare is important for every Nigerian family. But hospital bills can be expensive. That’s why many people look for affordable health insurance. One common option is the NHIS — the National Health Insurance Scheme in Nigeria. But the big question is:
Is NHIS in Nigeria worth it for families?

What Is NHIS in Nigeria?

The National Health Insurance Scheme (NHIS) is a government-backed health insurance program in Nigeria. It helps families and individuals pay for medical care. It is managed by the National Health Insurance Authority (NHIA).

The goal of NHIS is to make healthcare affordable for all Nigerians, especially for low and middle-income families.

Who Can Use NHIS?

  • Federal Government Workers (civil servants)

  • Self-employed People

  • Private Workers and Small Business Owners

  • Students

  • Families and Children

  • Pregnant Women

  • Retirees

Yes, you don’t have to work for the government to use NHIS anymore. Now, even private citizens and families can join through different programs like the GIFSHIP plan.

How Does NHIS Work for Families?

H2: Step-by-Step Breakdown of How NHIS Works

  1. You Register under the NHIS scheme (for yourself or your whole family).

  2. You Choose an HMO (Health Maintenance Organization) approved by NHIA.

  3. You Pay a Yearly Fee or Premium (can be monthly too, depending on plan).

  4. You Get a Health Insurance Card with details of your HMO.

  5. You Visit Hospitals or Clinics under your HMO’s network when you are sick.

  6. NHIS Pays for Some or All of the treatment, depending on the plan.

Types of NHIS Plans for Families

There are different types of NHIS plans based on who you are and what your income is.

1. Formal Sector Plan (For Government Workers)

  • Paid by both the employer and employee (like salary deduction).

  • Covers worker, spouse, and up to 4 children under 18.

2. Informal Sector Plan / GIFSHIP (For Everyone Else)

  • GIFSHIP = Group, Individual, and Family Social Health Insurance Program.

  • Open to families, students, private workers, business owners.

  • You pay directly — no employer needed.

  • Covers you, your spouse, and up to 4 children.

  • You can pay for more family members if needed.

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3. TISHIP (Tertiary Institutions Social Health Insurance Programme)

  • For university and polytechnic students.

  • Usually organized by the school and paid in school fees.

  • Covers common illnesses and basic hospital care.

How Much Does NHIS Cost for Families in Nigeria?

NHIS Cost Breakdown (Per Person / Per Family)

Plan Type Who Pays? Estimated Cost (₦) Coverage
Formal Sector (Gov Workers) Salary deduction ~1.5% of basic salary Worker + Spouse + 4 Children
GIFSHIP (Private Citizens) Self-funded ₦15,000 – ₦60,000 per year Individual / Family
TISHIP (Students) School Fees ₦1,500 – ₦3,000 per year Basic outpatient care
Extra Dependents Add-on ₦10,000+ per person/year Additional kids or family

Note: Prices may change. Always confirm with your chosen HMO or NHIS office.

What Does NHIS Cover for Families?

NHIS Coverage in Nigeria – Services and Benefits

Here are the healthcare services that NHIS generally covers:

 Basic Services Included

  • Outpatient care (consultations, drugs, tests)

  • Inpatient care (hospital stays, surgeries)

  • Maternity care (antenatal, delivery, postnatal)

  • Family planning services

  • Immunizations

  • Eye and dental care (basic)

  • Minor surgeries

  • Laboratory tests

  • Emergency care

Services Not Covered or Limited

  • Complex surgeries (heart, cancer, transplants)

  • Chronic disease treatments (unless listed)

  • Private ward requests

  • Luxury treatments

  • Cosmetic surgeries

  • Fertility treatments (e.g., IVF)

Always check with your HMO provider for what is specifically covered in your plan.

Is NHIS Better Than Private Health Insurance?

NHIS vs Private Insurance – Full Comparison Table

Feature NHIS (Gov Scheme) Private Health Insurance
Cost Lower; government-subsidized Higher; full premium by user
Coverage Basic to Moderate Basic to Very Comprehensive
Speed of Service Slower in some areas Generally faster
Hospital Network Limited but growing Wider options (especially premium plans)
Flexibility Limited Highly flexible
Add-Ons Few or none Many (dental, eye, wellness, telemedicine)
Ideal For Budget-conscious families Families wanting luxury or fast service

Advantages of NHIS for Families in Nigeria

Top Reasons Why NHIS May Be Worth It for Your Family

  1. Affordability: Very low yearly premium.

  2. Covers the Whole Family: Worker + spouse + 4 children.

  3. Free Basic Treatments: Saves money on hospital bills.

  4. Maternal and Child Care: Good for pregnant women and babies.

  5. National Coverage: Access in all 36 states + FCT.

  6. Approved HMOs: Choose from dozens of regulated HMOs.

  7. Reduces Out-of-Pocket Spending: Avoid spending savings on emergencies.

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Disadvantages of NHIS for Families

Common Complaints and Limitations

  1. Long Waiting Time in some public hospitals.

  2. Limited Coverage for serious illnesses (cancer, kidney, heart).

  3. Quality of Care Depends on Hospital – not always great.

  4. Network Restrictions – you must use listed hospitals.

  5. No Coverage for All Children – only 4 kids by default.

  6. Claims Can Be Slow for some HMOs.

How to Register for NHIS in Nigeria

Step-by-Step Guide to Join NHIS (2025 Process)

  1. Visit NHIA Website: www.nhia.gov.ng

  2. Choose a Plan: Formal sector, GIFSHIP, TISHIP, etc.

  3. Download Forms: Or visit any NHIA state office.

  4. Choose an HMO: Pick from the list of approved providers.

  5. Fill Form & Submit: Online or physically at NHIA office.

  6. Pay the Premium: Direct bank deposit or NHIA platform.

  7. Get ID/Enrollment Number: Used at hospitals.

  8. Start Using Your Benefits: After waiting period (usually 60 days).

Where Can I Use NHIS in Nigeria?

  • Over 1,000 hospitals in all states

  • NHIS-approved clinics, teaching hospitals, and general hospitals

  • Use NHIA portal or call your HMO to check approved centers

Real-Life Examples

Example 1: The Okoro Family

  • Mr. Okoro is a civil servant in Abuja. His NHIS covers him, his wife, and 4 children.

  • Last year, his wife had a baby — the delivery cost ₦0 under NHIS.

  • The kids get free malaria treatment, immunization, and checkups.

  • They saved over ₦100,000 in medical bills.

Example 2: Ngozi – Self-employed Mother in Enugu

  • She signed up for GIFSHIP and pays ₦45,000/year for her family.

  • Visits a private NHIS-accredited hospital with shorter waiting time.

  • Gets basic tests, drugs, and antenatal care included.

Summary Table: Is NHIS Worth It for Families?

Conclusion: Should Your Family Use NHIS?

Yes — for most Nigerian families, NHIS is worth it.

It may not cover everything, but it helps reduce the burden of hospital bills. It is especially helpful if you have children, a pregnant spouse, or if you are on a budget.

If you want better service or special treatment, private health insurance may be a better (but more expensive) choice.

But for students, civil servants, and everyday working-class families, NHIS offers good value for money in 2025.

Top 10+ Frequently Asked Questions (FAQs)

1. Is NHIS free in Nigeria?

No, it’s not free. But it is very affordable, and some people (like federal workers) get partial payment from the government.

2. How many children can NHIS cover?

It covers up to 4 biological children under age 18. You can pay extra to add more.

3. Can students use NHIS?

Yes, through the TISHIP plan in universities and polytechnics.

4. Can a self-employed person join NHIS?

Yes! Use the GIFSHIP plan for individuals and families.

5. What is an HMO in NHIS?

An HMO (Health Maintenance Organization) manages your NHIS benefits and links you to hospitals.

6. How long does it take before NHIS starts working?

Usually, 60 days after registration.

7. Can I change my HMO?

Yes, you can request a change after 6 months.

8. Is NHIS only for federal workers?

No. It used to be, but now anyone can join under GIFSHIP.

9. Does NHIS cover surgery?

Yes, minor and some major surgeries, but not all complex ones.

10. What if I live in a rural area?

NHIS is expanding to rural areas. Ask for nearby NHIS hospitals via your HMO.

11. How do I check if a hospital is NHIS-approved?

Visit nhia.gov.ng or ask your HMO directly.

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