If you have been searching for the NHIS, here is the first thing to know. The National Health Insurance Scheme (NHIS) no longer exists as a separate body. It is now the National Health Insurance Authority (NHIA), following the NHIA Act signed in May 2022. This guide is for any Nigerian who wants health cover in 2026, whether you are salaried, self-employed, or running a small business. It explains what changed, who must enrol, how to register step by step, and what it is likely to cost.
The National Health Insurance Authority is Nigeria's government agency for expanding access to affordable healthcare through insurance. Its job is to make sure Nigerians can pay for quality care without facing crushing out-of-pocket bills.
This matters because most Nigerians still pay for treatment out of pocket. Surveys have repeatedly shown that a large majority of adults fund their health costs directly, and only a small share hold any insurance. When a serious illness strikes, that gap can push a family into real financial hardship, and the real cost of going without cover usually only becomes clear once something goes wrong.
Health insurance spreads that risk. You pay a set premium, and your accredited Health Maintenance Organisation (HMO) and hospital handle covered treatment when you need it. The NHIA sets the rules, accredits the HMOs, and oversees the system.
The old National Health Insurance Scheme launched in 2005 under a 1999 law. It was largely voluntary and, in practice, covered only a small slice of the population, mainly federal civil servants. Enrolment stayed low for years.
The NHIA Act 2022 replaced that scheme. President Muhammadu Buhari signed it on 19 May 2022, and it repealed the earlier NHIS law. Three changes stand out for ordinary Nigerians.
First, the name signals the shift. An "Authority" regulates and enforces, whereas a "Scheme" simply ran a programme. Second, enrolment is now framed as mandatory for all Nigerians, not optional. Third, the Act strengthened State Social Health Insurance Agencies and created a Vulnerable Group Fund to cover people who cannot pay, such as the poor, pregnant women, and children.
The direction of travel is clear. Confirm the latest enrolment numbers from NHIA annual reports or official statements before publication. So, more Nigerians are now covered than under the old scheme. If you want the bigger picture before you enrol, our complete guide to comparing health insurance plans in Nigeria walks through every route to cover.
The NHIA does not use a single one-size-fits-all product. It runs several programmes, and your route in depends on your situation.
|
Programme |
Who it is for |
How you join |
|
Formal Sector (FSSHIP) |
Government and public-sector employees |
Through your employer |
|
Organised Private Sector (OPSSHIP) |
Private companies with 5 or more staff |
Employer registers all staff |
|
GIFSHIP |
Self-employed, informal workers, families, SMEs, individuals |
Through an accredited HMO, often as a group |
|
Vulnerable Group |
Pregnant women, children, the elderly, persons with disability |
Via the Vulnerable Group Fund and state agencies |
|
State Schemes (SSHIAs) |
Residents of a given state |
Through your State Social Health Insurance Agency |
A quick note on the private sector. State that the requirement applies under OPSSHIP guidelines rather than presenting it as a direct provision of the NHIA Act. Smaller businesses with fewer than five staff are not currently forced to enrol under OPSSHIP, but their workers can still get cover individually through GIFSHIP. Employers weighing their options can start with our guide to comparing health plans for businesses.
For most self-employed Nigerians and families, GIFSHIP is the main door in. It is designed for people outside formal employment, and it also works for associations, cooperatives, and small groups.
Gathering these first will save you time and avoid delays at activation.
Step 1: Confirm which programme applies to you. Salaried at a company with five or more staff? Your employer handles it. Self-employed or covering your family? GIFSHIP through an HMO is your route. A resident wanting a state plan? Start with your State Social Health Insurance Agency.
Step 2: Choose an NHIA-accredited HMO. Only accredited HMOs satisfy the law and give you valid cover. Confirm accreditation before you pay anything, and use our checklist on what to look for when comparing HMO plans so you weigh hospital network and benefit limits, not just price.
Step 3: Select your Primary Healthcare Provider. Pick a facility that is convenient for you and accredited under your chosen HMO. Under GIFSHIP, you generally have the right to choose your HMO and your HCP. Under employer-led OPSSHIP, the employer may assign the HMO, so confirm which one you are on and which hospitals it covers near you.
Step 4: Gather your documents. Have your NIN, passport photograph, personal details, and dependant information ready in one place.
Step 5: Submit your application. For OPSSHIP, the employer applies on behalf of staff and submits the documentation. For GIFSHIP, a group submits an application, usually covering ten or more people, listing each enrollee with their NIN. Clarify that enrolment structures vary by HMO and state implementation.
Step 6: Pay your premium. Pay the agreed amount for your plan and dependants. Keep your payment reference.
Step 7: Get your confirmation. You will receive enrolment confirmation and, depending on the HMO, an enrollee ID or card. Check that your details and assigned facility are correct.
Step 8: Activate and use your cover. Note any waiting period before certain benefits begin. When you need care, go to your assigned HCP first. For secondary or tertiary treatment, your HMO may need to issue a pre-authorisation code, so involve them early.
If you are still deciding between providers, our ranking of the top health insurance plans in Nigeria for 2026 compares hospital networks, premiums, and coverage limits side by side.
Premiums vary by HMO, plan tier, group size, and how many dependants you add. The figures below are indicative 2026 examples, not fixed national prices, so treat them as a guide and confirm the latest with your HMO.
|
Route |
Indicative 2026 cost |
Notes |
|
GIFSHIP, per person |
Around ₦38,718 per year |
Example premium quoted by one HMO in March 2026 |
|
GIFSHIP, group entry |
About ₦220,000 for a 10-person package |
Additional members: roughly ₦22,000 each per year |
|
Employer group plan |
Around ₦80,000 per employee per year |
Market estimates for a standard tier; varies widely |
To put that in context, an ₦80,000 annual plan works out to under ₦7,000 a month per person. That is often less than the cost of a single private hospital consultation, which is the case health insurance is built to make.
Prices have also climbed over the last two years, and many Nigerians quietly overpay for the cover they hold. It is worth checking whether you could save money by comparing HMOs before you renew or sign up.
If you earn a steady salary, the smartest move is to confirm exactly what your employer already provides before buying anything extra. Many staff are enrolled through OPSSHIP without realising it, so find out your HMO, your assigned hospital, and what your plan covers. If your employer offers nothing, or you want wider cover for your family, a GIFSHIP plan can fill the gap. Compare two or three accredited HMOs on premium, hospital network, and benefit limits, rather than picking the first name you hear.
If you are self-employed or supporting a family, think in terms of the whole household, not just yourself. A plan that covers your spouse and children shields you from the single biggest financial shock most Nigerian families face: an unexpected hospital bill. Budget the annual premium the way you would school fees, as a fixed yearly cost that buys peace of mind. Start with the benefits your family actually uses, such as consultations, malaria treatment, maternity, and childhood illnesses, then confirm the nearest accredited clinic is one you would be happy to visit.
No. The National Health Insurance Scheme was replaced by the National Health Insurance Authority under the NHIA Act 2022. People still say "NHIS" out of habit, but the correct body today is the NHIA.
The NHIS was a mostly voluntary scheme with low coverage. The NHIA is a regulatory authority, and enrolment is now mandatory for all Nigerians. The NHIA also accredits HMOs and funds cover for vulnerable groups.
Yes, the NHIA Act 2022 makes health insurance mandatory for all Nigerians. In practice, enforcement is still growing, but the legal requirement is in place, including for private businesses with five or more staff.
Yes. The GIFSHIP programme is designed for people outside formal employment, including the self-employed and informal workers. You enrol through an NHIA-accredited HMO, and you will need your NIN.
Cover typically extends to one spouse and up to four biological children under 18. Additional dependants can often be added for an extra premium. Confirm the exact benefit package with your chosen HMO.
Only use HMOs accredited by the NHIA. You can verify an HMO's accreditation status with the NHIA before you pay and confirm which hospitals it covers in your area.
The shift from the NHIS to the NHIA is more than a name change. It moves Nigeria towards health cover for everyone, backed by a stronger regulator and a clearer set of programmes for salaried workers, the self-employed, families, and vulnerable groups. Enrolling is now a practical step you can take in an afternoon, once you know your route and have your NIN ready.
The best decision is an informed one. Before you commit to an HMO, use our complete guide to comparing health insurance plans in Nigeria to see how premiums, hospital networks, and benefits stack up against each other.
Terms and conditions apply. Please verify all details, including exclusions, waiting periods, and covered facilities, with the HMO and the NHIA before enrolling. This is for informational purposes only and does not constitute financial or medical advice.