An HMO for an older parent in Nigeria: what to look for

Start with the numbers that matter for someone over 60

• Inpatient limit. Basic tiers can cap at N150,000 a year; a single admission at a private hospital can pass that. Mid and upper tiers run from N500,000 into the millions.
• Surgery limit and the surgical waiting period. Some plans exclude surgery in year one; others wait 6 to 12 months. For a parent in their seventies, a plan that starts paying for surgery in a year is a plan for next year.
• Chronic disease management. Hypertension affects around a third of Nigerian adults and more than half of over-50s across Africa; diabetes about 7% of adults. Check the wait for chronic care (often 3 months) and the drug limit.
• Ward days. 7 to 20 a year is the usual range.

Then the rules

• Age. Many retail plans have an upper age limit or a higher price band above 60 or 65. Ask directly whether the member's age is accepted and at what price.
• Pre-existing conditions. Excluded, delayed or capped depending on the HMO. Get the answer in writing for the member's actual conditions.
• Exclusions. Treatment abroad, transplants, joint replacements, congenital conditions and unlisted treatments are commonly excluded.
• Authorisation. The NHIA requires codes within an hour and emergencies to be treated first; delayed codes remain the most common complaint. Ask the hospital, not the HMO, how that HMO behaves in practice.

Then the network and the hospital

A plan is only as good as the nearest hospital in its network. Get the list for the member's area and check the two hospitals the family would use. Ask those hospitals whether they still take a cash deposit on emergency admission from HMO members; in Lagos many do, at N50,000 to N200,000.

Then the price

Individual plans in Lagos ran from about N24,000 to over N700,000 a year in 2025 and 2026. The Lagos State scheme, Ilera Eko, was N15,000 a year in August 2026 with a 30-day wait and around 400 facilities. A cheap plan whose limits fall short of an admission is a card, not a plan.

What Kinship Well adds

Kinship Well provides health benefits in the member's name through the Care Partner's arrangement with a licensed provider, with the full schedule given to the member on enrolment. Around it: a Kinkeeper who knows the schedule and the hospital, a doctor to talk to before a hospital visit, and Kinship Visits so someone qualified can be alongside the member at an appointment. Relatives abroad chip in; the plan stays the member's.

Related

• HMOs in Nigeria explained
• Health insurance in Nigeria explained