NATIONAL HEALTH INSURANCE AUTHORITY ACT

What Is This Policy?

The National Health Insurance Authority Act 2022 replaces the defunct National Health Insurance Scheme (NHIS) Act 1999, establishing a reformed, mandatory health insurance framework designed to move Nigeria toward Universal Health Coverage (UHC) by ensuring all Nigerians have financial protection against the cost of healthcare services.

Who Does It Target?

All Nigerians and legal residents, with mandatory enrolment for formal sector employees and their dependants Informal sector workers, self-employed persons, and rural populations previously excluded from health insurance Vulnerable groups: children under five, pregnant women, the elderly, and persons with disabilities who may access subsidised coverage Public and private sector employers required to enrol employees and contribute to premiums

What Does It Aim to Achieve?

Achieve Universal Health Coverage for at least 80% of Nigerians by 2030 under the SDG 3.8 target Eliminate catastrophic out-of-pocket health expenditure, which currently accounts for over 70% of total health spending in Nigeria Pool health risks across the population so that the healthy subsidise the sick and the wealthy subsidise the poor Strengthen state health insurance schemes, which the NHIA is required to coordinate, certify, and integrate into the national framework

Key Features

Mandatory Coverage: The Act makes health insurance mandatory for all Nigerians, unlike the voluntary NHIS which covered only about 3% of the population in 22 years Basic Minimum Package: A defined Basic Minimum Package of Health Services (BMPHS) covers primary care, selected secondary care, maternal and child health services, and emergency care Equity Fund: A vulnerability pool within the scheme provides subsidised coverage for the extremely poor, children under five, and pregnant women from government revenue State-National Integration: State Health Insurance Agencies are formally integrated into the national framework; the NHIA certifies state schemes to ensure minimum benefit standards Multiple Payers: Health Maintenance Organisations (HMOs) are retained as approved payers; the NHIA acts as regulator, not sole payer Portability: Coverage is portable nationwide; enrolees can access healthcare in any state, not just where they enrolled

Current Status

Rollout Stage: Active; NHIA fully operational from 2023; expanded enrolment drive ongoing across all 36 states and FCT Implementing Body: National Health Insurance Authority (NHIA); State Health Insurance Agencies; licensed Health Maintenance Organisations (HMOs) Coverage Rate: As of 2023, approximately 8 to 10% of Nigerians have health insurance coverage; the target is 80% by 2030 Funding: Employer and employee payroll contributions (10% of basic salary: 5% employer, 5% employee); federal government equity fund; state government subsidies

How to Access

Formal Sector Employees: Your employer should register you with the NHIA and a licensed HMO; if not enrolled, contact HR or the NHIA directly at nhia.gov.ng Informal and Self-Employed: Register at any NHIA state office or through a community-based health insurance scheme; premiums vary by income tier Vulnerable Persons: Access subsidised enrolment through the Equity Fund; contact the National Social Safety Nets Coordinating Office or State Primary Health Care Development Agency Contact: NHIA: nhia.gov.ng | 0800 NHIA CARE (6442 2273) | 22 Dar es Salaam Street, Wuse Zone 5, Abuja

Important Terms

Mandatory Enrolment: The Act makes health insurance compulsory; employers who fail to enrol employees are liable to a fine of N500,000 per unregistered employee Premium Contributions: 5% of monthly basic salary from employer and 5% from employee; informal sector premiums set at a flat community rate

Official Resources

Website: nhia.gov.ng Contact: NHIA, 22 Dar es Salaam Street, Wuse Zone 5, Abuja | 0800 6442 2273 | [email protected] Policy Summary | Source: NHIA, National Health Act 2014, Channels TV, Punch Nigeria, WHO Nigeria UHC Report 2023 | February 2026

Legal Framework

The National Health Insurance Authority Act 2022 establishes the NHIA and replaces the National Health Insurance Scheme Act 1999. It derives constitutional authority from Section 17 of the 1999 Constitution on health rights. The Act operates alongside the National Health Act 2014, the Basic Health Care Provision Fund framework, and aligns with the WHO Universal Health Coverage (UHC) global monitoring framework and the SDG 3.8 target on financial risk protection in health.