Ultimate Health Management Services has launched a new National Health Insurance Authority (NHIA)-backed health insurance package targeted at millions of Nigerians in the informal sector, in a major push to expand health insurance coverage and accelerate the country’s drive towards Universal Health Coverage (UHC).
The product, known as the U-Health Group, Individual and Family Social Health Insurance Product (GIFSHIP) and branded as U-Health Giveshield, is designed to provide affordable access to quality healthcare for individuals, families, market associations, transport unions, artisans, professional bodies, organised groups and small and medium-scale enterprises.
Speaking, Managing Director and Chief Executive Officer of Ultimate Health Management Services, Dr Lekan Ewenla, described the initiative as a significant step towards making healthcare more affordable, accessible and equitable for Nigerians who have largely remained outside the formal health insurance system.
He said the package adapts the actuarially developed benefit structure originally created for the Federal Civil Service Health Insurance Programme in 2005 and extends it to the country’s vast informal economy, which accounts for about 85 per cent of the population.
According to him, the product aligns with the operational guidelines of the NHIA following the amendment of the NHIA Act in 2022, which made health insurance mandatory for all Nigerians.
Ewenla disclosed that Ultimate Health HMO currently manages healthcare services for about 300,000 beneficiaries under the Federal Civil Service Health Insurance Programme, which now covers more than 11 million Nigerians nationwide.
He said the company decided to leverage its experience under the federal scheme to broaden access to quality healthcare for underserved groups.
“The annual premium for the package is fixed at N38,718 per enrollee, with the amount covering a monthly capitation of N1,450 and N700 for fee-for-service in line with NHIA regulations.”
Ewenla stressed that the initiative goes beyond selling health insurance, saying it is intended to strengthen collaboration between health maintenance organisations and healthcare providers, improve service delivery, and rebuild public confidence in health insurance.
Explaining further, Head, Medical Services, Ultimate Health HMO, Dr Chima Madu, said the benefit package covers outpatient and specialist consultations, laboratory investigations, prescription medicines, chronic disease management, emergency care and hospital admission of up to 21 days annually.
He added that maternal and child healthcare services, including antenatal care, normal delivery, caesarean section, neonatal care and postnatal care, as well as dental, eye, ear, nose and throat services, selected surgical procedures and telemedicine, are also included.
Madu explained that CT scans and MRI investigations would attract co-payment, while renal dialysis, physiotherapy, optical services and cancer treatment would receive partial financial support under existing NHIA cost-sharing arrangements.
He noted that treatment for occupational injuries, natural disasters, cosmetic surgery, home visits, family planning commodities, in-vitro fertilisation, patient evacuation, and some highly specialised congenital procedures are excluded from the package, while enrollees will observe a 60-day waiting period before accessing full benefits.
Immediate past president, Health Care Providers Association of Nigeria, Dr Jimmy Arigbabuwo, called for broader stakeholder engagement before the full implementation of the scheme.
He also urged stronger public awareness campaigns to increase enrolment and fast-track the achievement of universal health coverage.
Also, Market Leader, Computer Village, Mrs Adesola Azeez, appealed for flexible premium payment options, noting that many informal sector workers may find it difficult to pay annual premiums at once.
She expressed concerns about the use of generic medicines and called for an effective complaints resolution system.
(The Sun)
