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. 10 to 20 a year is common on mid-priced plans (2025); the cheapest plans can allow as few as two (June 2026).

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 ran from about N12,000 to over N340,000 a year in 2025 and 2026. A press survey of ten low-cost individual plans in June 2026 priced them from N12,000 to N120,000 a year; the cheapest paid for two days on a general ward a year, and where a surgery limit was stated it ran from N80,000 to N300,000. For the Lagos State scheme, Ilera Eko, the state gave the individual premium as N15,000 in August 2026, against N8,500 a year for its basic individual plan in May 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 the Kinship Plan adds

The Kinship Plan adds the Kinship care team and Kemi, who provides check-ins and reminders in the Kinship app. In Lagos, Kinship Visits add support at home, of which nurse visits are one type, and a named Kinkeeper who coordinates from the desk and reviews each visit report. An HMO pays for treatment; the Kinship Plan does not.

Related

• HMOs in Nigeria explained
• Health insurance in Nigeria explained