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The short answer
In Nigeria you can budget for health through a state social health insurance scheme, NHIA cover through an employer, a private HMO plan, or paying out of pocket. Published prices run from a few thousand naira a year on some state schemes to hundreds of thousands for private family plans, and every option still needs a monthly reserve for co-payments, drugs and care outside the plan.
Your four options, side by side
The National Health Insurance Authority Act 2022 made health insurance mandatory for all Nigerians and legal residents, allowed states and the FCT to run their own schemes, kept private insurance legal, and said vulnerable people should not pay premiums, according to The ICIR's summary of the Act. In practice most households end up in one of four positions, and many combine two.
| Option | Who it suits | What you budget for |
|---|---|---|
| State social health insurance (for example Ilera Eko in Lagos, OYSHIA in Oyo) | Self-employed, informal workers, families on modest incomes | A yearly premium plus travel to your assigned facility |
| NHIA formal sector programme through your employer | Public and organised private sector staff | Your payroll contribution plus anything the package excludes |
| Private HMO plan (individual, family or small business) | People who want a wider hospital list or private wards | A larger premium, co-payments and sub-limits |
| Out of pocket | No one by choice; common in practice | Every consultation, test and drug at full price |
What the published prices say
State schemes
KPMG's summary of the Lagos Executive Order on health insurance, effective 16 July 2024, lists Ilera Eko premiums for an individual and a family (principal, spouse and four children): Standard Family ₦8,500 and ₦40,000; Standard Plus ₦15,000 and ₦70,000; Higher Institution ₦5,000 and ₦10,000. A LASSRA number is needed to enrol. These are 2024 figures, so confirm the current amount and payment period with LASHMA before you budget.
In Oyo, Radio Nigeria reported the state scheme premium at ₦13,500 a year, with separate plans for pensioners, students and the diaspora. Other states run their own schemes; check your state health insurance agency for its current premium.
NHIA through work
The NHIA's own FAQ says the formal sector programme covers the contributor, a spouse and four biological children under 18, with extra dependants registrable. Its contribution answer gives employer 10% and employee 5% of basic salary, and in the same answer 3.25% and 1.75% of a consolidated salary, so check your payslip and HR for the split that applies to you. The FAQ also says there are exclusions and partial exclusions, and that dialysis is limited to six sessions a year.
Private HMOs
Reliance HMO's small business page (for groups of 3 to 19 principals, last updated 16 October 2026) lists annual prices per person from ₦68,400 (Red Beryl, staff only) to ₦268,850 (Red Diamond), with family cover from ₦232,000 to ₦1,482,000. Each tier carries a total benefit limit, from ₦2 million to ₦7 million per enrollee, and separate caps on dental, eye care and maternity.
For individual plans, NairaCompare's June 2026 cost report gives market ranges rather than quotes: about ₦30,000 to ₦80,000 a year for basic outpatient cover, ₦80,000 to ₦200,000 for standard, and ₦300,000 to ₦700,000 for a standard family plan of four. It notes waiting periods of 6 to 12 months for disclosed pre-existing conditions and 9 to 12 months for maternity, and co-payments of roughly ₦500 to ₦5,000 at the point of care.
Turn the premium into a monthly line
Premiums are usually paid yearly, but your budget is monthly. Divide the annual premium by 12 and move that amount into a separate pot each month so the renewal does not land on one salary.
Worked example (labelled example)
A family of four in Lagos is choosing between a state plan and a private family plan. Figures below are examples built from the published prices above.
| Line | State plan route | Private HMO route |
|---|---|---|
| Annual premium (example) | ₦40,000 | ₦450,000 |
| Monthly set-aside for premium | ₦3,333 | ₦37,500 |
| Health reserve (co-pays, drugs, tests outside plan) | ₦10,000 | ₦7,500 |
| Total monthly health line | ₦13,333 | ₦45,000 |
The reserve is lower on the private plan only because a wider list usually means fewer things paid in full. On either route the reserve is not optional: drugs outside the plan's list, care outside the network and anything above a sub-limit are paid by you.
Setting the reserve line
- Start with what you spent on health in the last 12 months, including pharmacy runs and lab tests, and divide by 12.
- Add any known regular cost: blood pressure or diabetes drugs, antenatal visits, children's check-ups.
- Raise the reserve during any waiting period, when the plan will not yet pay for pre-existing conditions or maternity.
- Review it once a year. Prices move: the NBS put headline inflation at 14.63% year on year in September 2026.
If the reserve is not used, let it build into a small medical fund rather than spending it. A separate fund stops a hospital bill from becoming a loan. For spreading regular medication, see monthly medication costs, and for the wider safety net, how big your emergency fund should be.
What to check first
- Ask HR whether you are already enrolled under the NHIA formal sector programme or a company HMO, and who your dependants are on it.
- If you are self-employed, find your state scheme's current premium and the facility you would be assigned.
- For a private plan, ask for the hospital list, exclusions, waiting periods and sub-limits in writing before you pay.
- Check that the HMO is NHIA-accredited and keep your enrolment number with your ID.
Where Pryme fits
A Flexible Savings Box in naira can hold the monthly premium set-aside and the health reserve away from everyday spending. The Personal Assistant can remind you before a renewal is due; it prepares, and nothing moves without your approval. Pharmacies are among the sectors in Spaces.
Questions people ask
How much is NHIA health insurance per month?
Through an employer, the NHIA FAQ describes payroll contributions as a share of basic salary rather than a fixed fee. Check your payslip; the FAQ's own figures differ between basic and consolidated salary.
How much is Ilera Eko per year?
KPMG's 2024 summary lists the Standard Family plan at ₦8,500 for an individual and ₦40,000 for a family. Confirm the current figure with LASHMA.
Which is better, HMO or state health insurance?
A state plan costs less; a private HMO usually offers a wider hospital list and private wards. Compare the hospital list, exclusions and sub-limits, not just the premium.
Do I still need savings if I have an HMO?
Yes. Co-payments, drugs outside the list, waiting periods and benefit caps are paid by you, so keep a monthly health reserve.
Sources
- Key issues in Nigeria's new National Health Insurance Authority Act (The ICIR) · accessed Oct 2026
- NHIA frequently asked questions · accessed Oct 2026
- Lagos State Executive Order on subscription to health insurance (KPMG, Aug 2024) · accessed Oct 2026
- UHC: Oyo targets informal sector, insists on mandatory health insurance (Radio Nigeria Lagos) · accessed Oct 2026
- Small Business HMO Plan Benefits and Prices – Reliance HMO · accessed Oct 2026
- 2026 health insurance cost report (NairaCompare, 22 Jun 2026) · accessed Oct 2026
This article is general information, not financial, legal or tax advice. Products described are provided under the terms on this site and are subject to regulation and eligibility.