The Health Maintenance Organisation (HMO) or a preferred provider organisation (PPO) is not the only tittle that shows that you can rightfully gain access to healthcare service delivery; there are other questions that you need to ask before you choose a health plan.
The benefit of Health insurance plan is one-way Nigeria can enhance universal coverage, therefore, efforts are being made to devise a strategy to extend the coverage to other states as well as those employed in other formal sector outside this federal formal sector, as well as those employed in the informal sector.
The health insurance landscape can be complicated to navigate, that is why most Nigerians who are covered get health insurance through an employer.
This article gives a guide to what questions to ask when choosing the best plan for you and your family, whether it’s through the federal marketplace or an employer.
However, to choose a plan you need to compare types of health insurance plans. Most HMOs in Nigeria provides four health Insurance plans; Bronze, Silver, Gold and Platinum.
Know provider (HMOs) networks of specialists and hospitals, in this case you have to know and pick the nearest facilities that is convenient.
Compare out-of-pocket costs and ask of benefits which should be clearly laid out how much you will have to pay out of pocket for services. By so doing, that will put your family’s medical needs and look at the amount and type of treatment you have received in the past. Though it’s impossible to predict every medical expense, being aware of trends can help you make an informed decision.
Prior to the things to ask of , one of the challenges most health plan users complain of in Nigeria is that most HMOs may not cover some treatment due to the specialty and as well as some prescription drugs.
On this note, it is best advised you ask as earlier stated to Know provider (HMOs) networks of specialists and hospitals because HMOs are the most restrictive, limiting you to doctors in their network.
So, as an enrollee, the question to ask is to demand for a referral, where by you can from a primary care physician in the network referred to facilities where the service can be delivered.
However, note that just as not all health insurance plans cover all doctors, not all benefits are always covered. This is especially true for certain medications and alternative practices.
ANTHONIA OBOKOH
