Healthcare is vital in any country, the well being of the citizens should not be ignored, and it is the duty of the government that they receive the best of healthcare at an affordable and accessible rate and to Nigerian government, it is the establishment of HMOs.
The NHIS earlier years was a scheme set up by the government to cater to the needs of Nigerian workers, and over the years, the NHIS are the regulatory agency to cater for HMOs.
The introduction of HMOs (Heath Maintenance Organization) is one of the best options the Nigerian government chose to make health services affordable and accessible to citizens. They are subservient to the NHIS who set regulatory framework for their operation and promoting quality healthcare in Nigeria.
In Nigeria, the National Health Insurance Scheme (NHIS) was created as a social network program to provide easy access to quality healthcare in Nigeria at affordable cost. All registered Nigerians, received from the social health insurance programme healthcare coverage that needs to be paid for from a common pool of funds contributed by other participants.
HMOs in Nigeria Healthcare System
Health Maintenance Organization (HMOs) was formed as private entities to serve as agents of the NHIS and cover both the public and private sectors.
HMOs is a Formal Sector Social Health Insurance Programme that serves as a social health security system in which the healthcare of employees in the Formal Sector. Funds are paid for from the pooling of contributions made by employees and employers. Contributions for accessing healthcare using HMOs can be accessed by government entities, private entities, and individuals.
To secure health insurance, you will have to find an insurance provider (HMOs) with unique features that fit your health needs. HMO insurance provides health insurance coverage for a monthly or annual fee and is only limited to medical care.
Some Key Takeaways on HMOs
HMOs plans require that you first receive medical care services from a provider known as the primary care physician (PCP) assigned to you. They become your custodian of healthcare services, and you chose from the list of options offered to you by the HMO.
There are two types of healthcare plans that are alternatives to HMOs. They are Preferred Provider Organizations (PPOs) and point-of-service (POS) plans. You chose either the PPOs or POS plan when subscribing for an HMO.
Your HMO plan mandates you to see your PCP first, who will refer you to an in-network specialist. The PPO plan allows you to see a specialist without referral. This depends on your subscription rate, and your rate determines your service.
Your HMO plan warrants you to within your network of providers to receive coverage. With a PPO plan, you still have a network of providers, but you aren’t restricted to seeing just those physicians.
It will also be important to note for your well-being that HMO provides more comprehensive coverage to you.
HMO can be accessed by employers and employees of public and private sectors, informal sector employees, and other residents of Nigeria.
The creation of HMO is to ensure that quality healthcare is rendered to all participants, and the NHIA act of 2022 regulates the actions of HMO. It is essential that you register with an accredited HMO that meets your health needs to ensure you get proper medical service proficient anytime, any day.
It is worthy to note that healthcare is fundamental for citizens of a country. NHIS and HMOs play crucial roles to achieve this goal and this is by providing affordable and accessible healthcare.
Benefits of HMOs in Nigerian Healthcare
HMOs serves as agent of the NHIS and they offer range of benefits to you which include:
- Reduced cost price. HMOs negotiate lower price with healthcare providers to save expenses for their members.
- Improved healthcare access. Accessing healthcare providers through HMOs is easier. Members get care from network of healthcare providers.
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