How To Register An HMO In Nigeria
Registering an HMO in Nigeria has its benefits. Such benefits include access to quality healthcare services at discounted prices. It comes in handy during any health emergency or challenges. Registering an HMO in Nigeria involves lots of processes and paperwork, but it’s a prerequisite for firms and individuals.
This article seeks to break down the process involved in registering an HMO in Nigeria.
What Is An HMO?
HMO—an acronym for Health Maintenance Organization—is a form of medical insurance scheme that is deemed necessary by hospitals, firms, etc. The purpose of an HMO is to provide medical services to members at a reduced cost. HMOs act as a middleman between individuals, firms, and healthcare providers by managing payment processes and the quality of services provided.
An ideal system in every organization must give room for the provision of HMO services. This provides the payment for medical services of registered employees in case of emergencies or check-ups.
HMO extends its services to every branch of medical facilities, including dentistry, orthopedics, neurology, optometry, and other forms of medical departments. HMOs bridge the gap for people seeking affordable healthcare services. In addition, they are dedicated to ensuring medical centers provide optimum services to members.
HMO was introduced as a facilitator of the national health insurance policy in Nigeria. The health insurance policy also regulates the standard of healthcare management in the country.
In terms of pricing, HMOs offer flexible payment options that include basic, premium, or executive plans. These plans enable members to choose the appropriate package that fits their income status.
Features of HMO
- Dynamic:
HMOs are dynamic in the sense that they allow members to benefit from more than one medical center. Members have the privilege of choosing medical centers within their work or residential address.
- Scheduled Payment:
Members registered under an HMO usually pay in advance for their services. Members are usually charged on a monthly, quarterly, or yearly basis, depending on the HMO service provider. These payments are tagged “fixed” and non-refundable, regardless of whether a member utilizes medical services or not.
- Unlimited Healthcare Access:
There are several packages offered by HMOs, giving members access to emergency help, medical tests, medicines, surgeries, etc.
How Does HMO Work in Nigeria?
The function of an HMO service provider includes providing adequate medical care to members. One of the major reasons why Nigerians register for HMO is to afford medical services in emergencies. However, most people overlook knowing how HMO works before registering. This section seeks to explain how HMO service providers operate.
To get started with HMO in Nigeria, members must first select a primary healthcare facility to serve the purpose of diagnosis and treatment. Some HMO service providers assign specific fees on a monthly or yearly basis for clients, regardless of their medical conditions or frequent use of medical services.
HMO also covers payment with specialists in the medical field. Members may benefit from a partial waiver or free medical services from their HMO provider. However, this benefit is acquired after getting a referral from the primary medical health center.
Brief History of HMO in Nigeria
The introduction of HMOs in Nigeria dates back to 1999 after the national health insurance policy scheme was introduced to improve the quality of healthcare facilities in the country.
The organization faced several problems, such as mismanagement of funds, lack of accountability, limited medical services, and many others. Although the organization faced several challenges, it has evolved to be the largest insurance scheme benefiting millions of people in Nigeria.
Looking back in history, HMOs lacked several preventive services such as vaccination, medical checkups, X-rays, and other medical services, which were not included in the HMO service plan. HMOs in Nigeria have further made adjustments to their service plan by enabling adequate management and care of patient health. The service also caters to people with all types of medical ailments and chronic diseases.
Types of HMO
- Staff Model HMO:
This type of HMO caters to the medical needs of the organization’s staff. Qualified healthcare practitioners are responsible for diagnosing and treating members. However, members can receive referrals to a more equipped healthcare center. - Network Model HMO:
This type of HMO partners with more than one medical facility to deliver adequate services to its members. - Independent Practice Association HMO:
These types of HMOs are not affiliated with any form of medical center. They partner with specialists and other medical experts to deliver services to customers.
Benefits of HMO
- Cost:
Registering for an HMO is relatively low, and members only pay a small fraction of money on a monthly or yearly basis. HMO subscribers can access medical services at any given time, and there are no limits on how many times they can visit their primary care physician.
- Family Plan:
An HMO does not just cater to the medical services of an individual. It also extends the services to family members. Most HMOs allow a single individual to tie up to 5 more people in the family to their plan.
- Convenience:
HMO subscribers have the liberty of choosing their preferred primary healthcare physician. They can choose the nearest medical center or a center that suits their taste.
- Medical Standard:
HMO subscribers are entitled to receive optimum services from their service providers. This means members should expect the best when dealing with any form of medical condition or ailment.
- Free Monthly Medical Check-Ups
One of the benefits that come with using an HMO service is access to medical services and free checkups. Clients will be able to check their health status, such as heartbeat rate, pulse rate, blood pressure, blood sugar levels, etc.
Demerits of HMO
- Complexity:
HMO services are considered complex to some members because there’s a limit on how customers can utilize the services. For example, although customers are allowed to select any medical center for their diagnosis and treatment, members can only select medical centers that are registered under the network. A medical center registered under the HMO network may not always be close to a member’s location. This may affect the health and wellness of an individual in case of emergencies. In addition, people may feel reluctant to go for checkups if their primary care physician is not within their environment.
- Documentation Process:
There’s a documentation process involved in accessing the service of a specialist, such as a neurologist, optician, dermatologist, etc. Your primary care physician must first assess your condition and refer you to any specialist of their choice. You are not responsible for selecting the type of specialist hospital you want, and they may not be entirely responsible for the full cost.
- Fixed Payments:
HMO subscribers pay for medical services regardless of whether they visit their primary health physician. The HMO stands to gain more if there are no services rendered to the member.
How to Register HMO in Nigeria
This section will review the step-by-step guide involved in registering an HMO in Nigeria.
Step One: Register With NHIS
The National Health Insurance Scheme was birthed to improve the quality of healthcare services in Nigeria. The fastest route to register for an HMO in Nigeria is via the NHIS website. Visit www.nhusonline.com.ng to initiate your registration process.
However, the above process is for people trying to register individually. Most companies register HMOs for their staff and handle the paperwork on their behalf.
Step Two: Documentation:
This step involves inputting every relevant piece of information about yourself on the NHIS website. Ensure the data inputted is accurate to serve you better.
Step Three: Make Payments:
Reliable online payment options are available, but you can also use any of the other available payment options.
Step Four: Health Check:
This process involves a total evaluation of the member’s health. HMO will request the member to undergo a series of routine tests to have a better understanding of their medical history.
After following all the above steps, you will have successfully enrolled with an HMO service.
Conclusion
Registering for an HMO gives members access to free medical checkups, diagnosis, treatment, and referrals to specialist hospitals. Registration is simple and only involves visiting the official NHIS website to kickstart your registration and input the necessary information.
The benefits attached to registering an HMO go beyond the insurance policy. Members are also entitled to receive the best services in any medical center of their choice.