Nigeria Receives Health Boost as GIFSHIP Launches with Affordable Premium

For decades, Nigerians have struggled with the burden of healthcare costs, often facing financial ruin when illness strikes. But today, a new dawn breaks as Ultimate Health HMO launches GIFSHIP, a game-changing health insurance package designed to make quality healthcare accessible to all. Writes MARY NNAH

For years, Nigeria’s healthcare system has been plagued by inadequate funding, poor infrastructure, and a lack of access to quality care. But with GIFSHIP, Ultimate Health HMO is leading the charge to change this narrative.

In a bold move to accelerate Nigeria’s journey towards universal health coverage, Ultimate Health HMO has launched the Group, Individual, and Family Social Health Insurance Programme (GIFSHIP), a comprehensive health insurance package designed to make healthcare affordable, accessible, and equitable for all Nigerians.

GIFSHIP is more than just a health insurance package – it’s a lifeline for millions of Nigerians who have been denied access to quality healthcare. With a premium of ₦38,718 per person per annum, GIFSHIP is affordable, accessible, and equitable.

The package is regulated by the National Health Insurance Authority (NHIA) and offers a robust benefits package, including coverage for primary, secondary, and tertiary healthcare services.

Speaking at a press briefing in Lagos recently, Managing Director/CEO of Ultimate Health HMO, Otunba Lekan Ewenla, emphasised the importance of shifting from assumptions to action, citing the National Health Insurance Authority (NHIA) Act 2022, which makes health insurance mandatory for all Nigerians.

“We need to shift from merely treating illness to creating health. A healthy nation is a wealthy nation,” Ewenla declared. 

“The GIFSHIP package is a strategic step to strongly focus on the objectives of making healthcare affordable, accessible, and equitable”, he added.

The GIFSHIP package, priced at ₦38,718 per person per annum, offers a robust benefits package, including coverage for primary, secondary, and tertiary healthcare services. 

Ewenla highlighted that the package is designed to cater to the needs of individuals, families, groups, and corporate organizations, with a focus on the mass market.

“This is a game-changer for Nigeria’s healthcare sector,” Ewenla said. “The premium is not negotiable, the quality of care is guaranteed, and the premium is affordable. We are committed to delivering quality healthcare services to Nigerians, and GIFSHIP is a significant step in that direction.”

He explained that the NHIA Act 2022 has empowered the regulatory authority to approve and code private health insurance products, ensuring that HMOs deliver quality healthcare services to Nigerians.

 “The Authority shall ensure that health insurance is mandatory to every Nigerian and final residents. The NHIA shall enforce the basic minimum package of health services for all Nigerians across all health insurance schemes operating within the country, including federal, states, and the federal capital territory – FCT, as well as private health insurance schemes”, he noted.

The launch of GIFSHIP is expected to address the challenges of poor health indices in Nigeria, with Ultimate Health HMO targeting a significant increase in enrollment numbers. 

According to Ewenla, the package is designed to address the challenges of the past, including arbitrary premium reductions and varying benefit packages.

“We adopted the Health Risk Management Framework of the social health insurance program for the private health insurance packages, which recognizes two Risk Managers. In the social health insurance programme, the primary healthcare providers are the risk managers at the primary level, while the health maintenance organizations are the risk managers at the secondary and tertiary levels of care,” Ewenla explained.

The Capitation is a concept of transferring the health risk management responsibility at the primary level of care to the primary health providers, with 65% of the premium paid for a minimum of actuarially recommended population of at least 2,500 enrollees. The capitation is paid to the primary providers by the NHIA through the health maintenance organizations.

Ewenla also highlighted that the health maintenance organizations earn 10% of the public sector social health insurance premium as an admin fee, as they speak. The fee-for-service paid to the health maintenance organizations was to settle defined and denominated healthcare services through pre-authorization codes that must be issued by the HMOs.

“The good news is that all the challenges enumerated in the course of this briefing have been adequately addressed by the NHIA Act 2022, section 3, which says that the NHIA shall ensure that health insurance is mandatory for every Nigerian and legal residents,” Ewenla said.

The GIFSHIP package is regulated by the National Health Insurance Authority – NHIA and is very robust. The healthcare providers are familiar with the services covered at the three levels and have a better understanding of the operational process like calling the HMOs for pre-authorization codes and utilizing the NHIA tariffs for the secondary and tertiary services.

“We are changing the narration of our poor health indices, and we invite everyone to join us on this journey,” Ewenla said. “The GIFSHIP package is a strategic step to strongly focus on the objectives of making healthcare affordable, accessible, and equitable. We are committed to delivering quality healthcare services to Nigerians, and GIFSHIP is just the beginning.”

Ultimate Health HMO has already made significant strides in providing healthcare coverage to Nigerians, with a reasonable number of public sector enrollees and corporate organizations already on board. The launch of GIFSHIP is expected to further boost the company’s efforts, with Ewenla calling on Nigerians to join the journey towards universal health coverage.

“We are targeting the mass market with GIFSHIP,” Ewenla said. “We want to make healthcare accessible to every Nigerian, regardless of their social status or income level. We are committed to delivering quality healthcare services to Nigerians, and GIFSHIP is a significant step in that direction.”