Health Insurance Premiums Rise As Hospitals Jack Up Service Fees

Nigerians are now battling higher health insurance premiums as hospitals across the country raise service charges, LEADERSHIP has learnt.

Market sources hinted at a further hike in the New Year as the cost of accessing healthcare services continues to rise to levels that the masses can no longer afford.

The hike, it was learnt, is attributable to high inflation and soaring medical and drug costs. Rising hospital service fees are a primary driver of the spike in health insurance premiums in the country. Health insurance premiums reflect the overall cost of healthcare services, and as hospitals increase prices for everything from procedures to labour, insurers pass those expenses on to policyholders.

Patients, mostly enrolled under different health insurance packages, who spoke to LEADERSHIP, confirmed the increase, saying healthcare services are gradually becoming out of reach for the masses.

Although investigations show that there are some individual and family packages that are pocket-friendly, these packages are often fraught with delays at hospitals before services are accessed, as well as the provision of inferior drugs and treatments.

To, however, access better services, policyholders would need to upgrade their packages by about 30 to 40 per cent to enjoy moderate healthcare services, it was learnt.

The Standard package, which was earlier sold between N15,000 and N25,000 for individual and family plans, now costs between N35,000 and N65,000. The Gold and Platinum packages, which are comprehensive in nature, now range from N100,000 to N1 million and above per annum.

Health Maintenance Organisations (HMOs) attribute this development to hikes in other ancillary services such as drugs, injections, drips and consultancy fees.

From Lagos to Abuja and other parts of the country, patients are reporting sudden increases in consultation and treatment fees, leaving HMOs with little choice but to adjust policy rates upwards if they want policyholders to access premium services.

The development is sparking concern among families already struggling with rising food and fuel prices and igniting debate over the affordability of healthcare in Africa’s largest economy.

A trader at Mushin Market in Lagos, Ifeoma Okeke, while lamenting the hike, said:

“These HMO premiums have overwhelmed me. We used to pay modest amounts for basic necessities like check-ups and medications. Now, they have doubled or tripled. Many of us at the market eat garri just to cover school fees and transport. How can we manage insurance? It is overwhelming.”

Another patient, Anike Ayinla, highlighted the toll on household budgets.

“The pressure is immense. Healthcare now claims a larger share of our monthly spending, forcing cuts to food, utilities or savings. The fear of illness heightens stress, as one medical bill can upend a family. For many, staying healthy feels like a financial gamble,” he said.

On his part, the national secretary of Private Medical Doctors, Dr Gbadebo Adebiyi, said the increase in private hospital charges is not excessive per se.

To illustrate this, he said the national health insurance price moved up by about 100 per cent; however, the increase in the cost of drugs is even more staggering, with some recording over a 400 per cent rise.

Moreover, he said the cost of a single malaria drug—one of the most common illnesses affecting Nigerians—is already higher than the premium being offered.

“And it is not only one drug that is prescribed. Patients also receive pain relief and other medications depending on their complaints.

“Therefore, the premium is still nothing to write home about compared with what hospitals are facing under the current inflationary pressures in the country,” he stressed.

Dr Adebiyi further explained that the reality on the ground has necessitated hospitals increasing service charges.

He said: “Inflation has come in, and prices have gone up. Except we deceive ourselves by saying we still want to maintain old rates, no businessman will use his money to service another person’s clients when those responsible for paying are not paying the right amounts.

“As a result, most private hospitals are going through bankruptcy because they can no longer cope with what the insurance is offering. Many hospitals now prefer not to attend to insurance patients and would rather close down their facilities than continue running at a loss,” he declared.

Furthermore, he said workers’ salaries have risen sharply.

“Doctors, for example, who used to earn an average of N120,000 per month now earn a minimum of around N450,000—and that is for just one doctor. On top of that, hospitals must still pay other staff, while insurance reimbursements remain lower than the cost of drugs.

“Consequently, there is no way hospitals can cope with such a situation, and that is why many doctors are leaving the system or even leaving the country altogether. Because of this, we met with the National Health Insurance Authority, and they realised things cannot continue as they are. Although they increased the rates, the increment is still not commensurate with the current reality in the country,” he pointed out,” he stated.

The immediate past national president of the Healthcare Providers Association of Nigeria (HCPAN), Dr Adeyeye Arigbabuwo, gave his view on the issue.

“Generally, the health sector cannot remain isolated. Like every other sector, it operates within the larger society.

“So the inflationary trend has affected even the cost of pharmaceuticals, drugs and medicines. They are not cheap, and they are changing in a dynamic you cannot predict,” he said.

Meanwhile, the director-general of the National Health Insurance Authority (NHIA), Dr Kelechi Ohiri, said insurance premiums have to increase because good-quality healthcare must be paid for.

“Unfortunately, over the years, medical costs and drug costs have risen. That is why the NHIA reviewed all tariffs, to ensure that what we reimburse doctors is commensurate.

“We conducted an elaborate costing exercise called an actuarial review to make that happen. Now, doctors are happier that they are getting reimbursement for good-quality care provided. I encourage all Nigerians to try and get covered by health insurance. That way, it is not when you are sick that you will have to pay out of pocket,” he stressed.

Earlier, the NHIA director general had said the agency was addressing drug shortages and care delays through a multi-pronged strategy.

Ohiri, who stated this at the recent annual general meeting of the Nigeria Association of Insurance and Pension Editors (NAIPE) in Lagos, highlighted NHIA’s strategic interventions from 2024 to 2025 to include tariff revision; complaint resolution; sanctioning non-compliant providers and HMOs; revising accreditation processes; and mandating a one-hour limit for care authorisation codes.

Represented by the deputy director, Lagos Zone, Mrs Aisha Abubakar Haruna, Ohiri noted that from 2024 to 2025, the NHIA has intervened strategically by revising tariffs, improving accreditation processes and mandating a one-hour care authorisation limit, while mitigating previous issues such as medicine shortages, denial of care, delays in issuing codes and provider payment delays.

He said: “A few years back, we upgraded to self-automation, but now we are fully automated in the accreditation of NHIA facilities. I can assure you that any facility we ascertain to have met the standards will meet international standards.

“We use SafeCare tools, and everything is done online. There are over 100 questions on the platform—the tool we use.”