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The short answer
Health insurance is mandatory for every resident under section 14 of the NHIA Act 2022, and you can get it through an employer, your state scheme or a private HMO accredited by the NHIA. Market ranges published in June 2026 put a standard HMO plan at ₦80,000 to ₦200,000 a year for an individual and ₦300,000 to ₦700,000 for a family of four, with 6 to 12 month waiting periods common for pre-existing conditions. In Lagos, the Ilera Eko scheme listed a Diaspora family plan at ₦353,490 in 2024.
Returnees used to the NHS, a Canadian provincial plan or an American employer policy often arrive in Nigeria unsure what health cover looks like here. In short: health insurance is now a legal requirement for residents, it is delivered through the National Health Insurance Authority (NHIA), state schemes and private health maintenance organisations (HMOs), and what you pay depends heavily on the plan. This guide explains the law, how enrolment works, what HMO plans cost by tier, and the waiting periods that matter most to people arriving with existing conditions.
The law: health insurance is mandatory
The National Health Insurance Authority Act 2022 replaced the old NHIS framework. KPMG Nigeria's commentary on the Act (June 2022) summarises the key provisions:
- Section 14 makes health insurance mandatory for every resident of Nigeria.
- Section 13 brings in employers and employees in organisations with five or more staff, and the informal sector.
- Under section 31, employers register with their State Health Insurance Scheme and remit contributions as state rules require, even where they also pay for private cover. State councils set contribution rates.
- A Vulnerable Group Fund covers groups such as children under five, pregnant women, the aged, people with disabilities and the indigent.
- Section 48 sets penalties for offences under the Act of up to ₦1 million and/or two years for a first offence.
nairaCompare's June 2026 report describes enforcement as rolling out gradually, and for most returnees the question is not whether they must have cover but which kind gives them access to good care. If you will be employed in Nigeria, ask your employer which scheme and HMO it uses before you buy anything yourself.
Three routes to cover
1. Through an employer
Formal-sector employees are usually enrolled by their employer with an NHIA-accredited HMO, which then assigns a primary care hospital. Employer plans vary widely; ask for the benefit schedule and the hospital list.
2. Through your state scheme
Each state runs its own health insurance agency. Lagos is the clearest example for returnees. KPMG's summary of the Lagos Executive Order (August 2024), effective 16 July 2024, says all Lagos residents must hold social health insurance under the Ilera Eko scheme, that a LASRRA residency number is a prerequisite, and that you enrol through the LASHMA website (choose a plan, enter details, choose a provider, pay) or through accredited HMOs. It lists plans including a Diaspora plan at ₦71,190 for an individual and ₦353,490 for a family, with a family defined as principal, spouse and four children. These are 2024 figures; check the current premium and the period it covers with LASHMA. In Abuja and other states, ask the state or FCT health insurance agency for its plans.
3. A private HMO plan
Most returnees who want wider hospital choice buy a private HMO plan, alone or on top of a state plan. NHIA accredits HMOs, and accredited HMOs carry NHIA code numbers, so check that any HMO you are considering is on NHIA's list before paying.
What HMO plans cost (labelled ranges)
There is no official price list for private plans. nairaCompare's 2026 health insurance cost report (22 June 2026) gives these market ranges, which it says are not provider quotes:
| Tier | Individual, per year | Family of four, per year |
|---|---|---|
| Basic outpatient | ₦30,000 to ₦80,000 | ₦150,000 to ₦300,000 |
| Standard | ₦80,000 to ₦200,000 | ₦300,000 to ₦700,000 |
| Comprehensive | ₦200,000 to ₦600,000 | ₦700,000 to ₦1,800,000 |
| Executive / premium | ₦600,000 and above | ₦1,800,000 to ₦5,000,000+ |
The difference between tiers is mostly in which hospitals you can use, whether specialist care, admissions and surgery are covered, and the limits on each. A basic plan may cover clinic visits and common drugs at a small network of hospitals; an executive plan typically opens the top private hospitals in Lagos and Abuja.
Waiting periods returnees should know about
- Pre-existing conditions: the same report says many plans impose 6 to 12 months before chronic conditions disclosed at enrolment are covered, and some exclude specific conditions entirely.
- Maternity: most plans require a 9 to 12 month wait.
- Dental, optical and some extras: often activate only after a set period.
If you or a family member takes regular medication for hypertension, diabetes or asthma, budget to pay for it yourself during the waiting period, and bring enough supply to bridge the gap; see our guide to bringing medication into Nigeria.
Worked example (labelled)
Example: a returning family of four in Lekki choose a comprehensive HMO family plan at ₦1,200,000 a year, within the 2026 market range. One parent has hypertension, so medication of about ₦25,000 a month is not covered for the first six months.
- Premium: ₦1,200,000.
- Uncovered medication during the waiting period: ₦25,000 × 6 = ₦150,000.
- Example first-year health cost: ₦1,200,000 + ₦150,000 = ₦1,350,000.
The same family on the 2024-listed Ilera Eko Diaspora family plan would pay ₦353,490 in premium, but with a different hospital network and benefit list. Compare the hospital lists, not only the price. For the wider picture of first-year costs, see our first-year budget for Lagos or Abuja.
Steps to get covered
- Ask your employer, if you have one, which scheme and HMO it uses.
- Register for your state scheme where required (in Lagos, get your LASRRA number first).
- Shortlist two or three NHIA-accredited HMOs and request each plan's benefit schedule and hospital list.
- Check that the hospitals you would actually use are on the list for your tier.
- Ask in writing about waiting periods, exclusions, annual limits and how to get authorisation codes for referrals.
- Keep NHIA's complaints channels handy: its FAQ lists info@nhia.gov.ng and phone lines for enrollee complaints.
Where Pryme fits
Pharmacies are one of the sectors in Spaces, Pryme's merchant ecosystem in Lagos, Abuja and Port Harcourt. Where a pharmacy is in Spaces, Solid Allianze MFB may offer a Loan on Spaces limit based on how your account is run, with the amount, cost and repayment date shown in full before you accept (Loans on Spaces). Annual premiums can be set aside in a naira Savings Box.
Questions people ask
Is health insurance compulsory in Nigeria?
Yes. Section 14 of the NHIA Act 2022 makes it mandatory for every resident, and Lagos made Ilera Eko cover compulsory for residents from 16 July 2024.
How much is HMO health insurance in Nigeria in 2026?
nairaCompare's June 2026 report gives market ranges of ₦80,000 to ₦200,000 a year for a standard individual plan and ₦300,000 to ₦700,000 for a family of four. Prices vary by HMO and hospital network.
Is there a health insurance plan for diaspora returnees in Lagos?
Lagos's Ilera Eko scheme listed a Diaspora plan at ₦71,190 for an individual and ₦353,490 for a family in 2024, according to KPMG's summary. Check the current premium with LASHMA.
Will an HMO cover my existing condition straight away?
Often not. Many plans apply a 6 to 12 month waiting period for pre-existing chronic conditions, and some exclude certain conditions.
Sources
- KPMG Nigeria: Commentary on the National Health Insurance Authority Act 2022 (Jun 2022) · accessed Oct 2026
- KPMG Nigeria: Lagos State Executive Order on subscription to health insurance (Aug 2024) · accessed Oct 2026
- nairaCompare: 2026 health insurance cost report (22 Jun 2026) · accessed Oct 2026
- NHIA: Frequently asked questions · accessed Oct 2026
- Nairametrics: HMOs carry NHIA code numbers (16 Mar 2024) · 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.