What Does NHIS Cover in Nigeria?

what does NHIS cover in Nigeria

Last Updated on January 2, 2023

The National Health Insurance Scheme in Nigeria, which was created by the federal government of Nigeria to offer easy healthcare for all, covers Nigerian citizens.

These citizens must either be government employees, in the organised private or informal sector, children under five, permanently disabled persons and prison inmates.

However, less than 5% of Nigerians are covered by NHIS.

See: Best HMO in Nigeria


What does NHIS Cover in Nigeria?


NHIS coverage and benefits in Nigeria include the following:

  • Receive Outpatient care or treatment (that is, a treatment that does not require an overnight stay in a hospital or medical facility), including necessary drugs, injections, and drip.
  • Receive prescribed drugs, pharmaceutical cares as well as diagnostic tests.
  • Receive maternity care for up to four (4) live births for every insured contributor/couple in the formal sector Program. Additional care is also available if any stillbirth occurs.
  • All live births requiring covering or incubation will be incubated appropriately during the post-natal period of twelve (12) weeks from the date of delivery.
  • All preterm/premature babies eligible for covering or incubation shall be covered for twelve (12) weeks from the date of delivery.
  • Preventive care includes immunisation as it applies in the National immunisation program, Health Education, Family planning (counselling), antenatal and post-natal care, as well as adult immunisation against Human papillomavirus (HPV) and hepatitis.
  • Consultation with a specialist such as physicians, paediatrics, obstetricians, gynaecologists, general surgeons, orthopaedic surgeons, ENT, dental surgeons, radiologists, psychiatrists, ophthalmologists and physiotherapists, etc.
  • Hospital care in a standard ward for a cumulative limited stay of 21 days per year.
  • Eye examination and care, the provision of low-priced spectacles but excluding contact lenses.
  • All ophthalmological cases can be handled at the primary level except those requiring tertiary care or on the exclusion list.
  • A range of prostheses (limited to artificial limbs produced in Nigeria).
  • Preventive dental care and pain relief (including consultation, dental Health education, amalgam filling and simple extraction).
  • Root-canal treatment; treatment is needed when an injury or a large cavity damages the tooth’s root (maximum of two treatments).

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