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At A Glance

Hygeia HMO is one of Nigeria's longest-standing health maintenance organisations, offering a wide range of individual plans from an affordable entry tier through to premium comprehensive cover, plus a dedicated set of senior plans for older enrollees. Plans are structured around hospital categories, giving you clear control over the level of facility you can access, and are backed by an accredited network of more than 1,600 hospitals, clinics, pharmacies, dental and optical centres spanning all 36 states and the FCT. Hygeia HMO is regulated by the National Health Insurance Authority.

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Claims & Support

Hygeia HMO uses a provider-direct model, so accredited facilities verify your cover and bill Hygeia directly for treatment received under your plan. Present your enrollee ID at any hospital within your plan's category before receiving non-emergency care. For emergencies, proceed to the nearest facility for resuscitative or lifesaving treatment and notify Hygeia as soon as possible. Unlimited 24/7 telemedicine is available on most plans, giving you a fast route to a doctor without visiting a hospital.

How to Make a Claim

Present your Hygeia HMO enrollee ID at an accredited facility within your plan's hospital category before treatment begins
For specialist care, obtain a referral from your primary care provider within the network
In an emergency, proceed to the nearest hospital for stabilisation and notify Hygeia as soon as possible after the event
Use unlimited telemedicine service for 24/7 access to a doctor for consultations and prescriptions
Contact Hygeia customer support through the details on your policy document for benefit queries or pre-authorisation of major procedures

Hygeia HMO Plans

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1.

HyEase (₦26,515 per annum): The entry-level individual plan, HyEase gives unrestricted access to Category C and D providers with an inpatient limit of ₦150,000 covering a general ward for up to 7 days per annum, inpatient medication, and surgeries up to ₦150,000. The outpatient limit is ₦100,000 covering GP consultations and up to 12 specialist visits per annum, with a medication limit of ₦50,000. Maternity cover includes antenatal care, normal delivery, postnatal care, and neonatal services, and NPI immunisations for children aged 0 to 5 are included. Telemedicine and a permanent disability and death benefit of ₦100,000 round out an affordable, regulated starting point.
2.

HyBasic (₦66,070 per annum) : HyBasic keeps Category C and D access but lifts the inpatient limit to ₦350,000 with a general ward for up to 15 days per annum and surgeries up to ₦150,000. The outpatient limit remains ₦100,000 with GP and up to 12 specialist consultations per annum, and unlimited 24/7 telemedicine is included. Chronic disease medication and outpatient prescription medicines are covered up to ₦50,000, making this a solid step up for enrollers who want longer admission cover and support for ongoing conditions.
3.

HyPrime (₦181,380 per annum): HyPrime expands access to Category B, C, and D hospitals with an inpatient limit of ₦500,000 in a semi-private ward for up to 15 days per annum and surgeries up to ₦200,000. The outpatient limit rises to ₦200,000, chronic disease medication to ₦85,000, and advanced investigations including CT, MRI, and echocardiograph are covered once per annum. Maternity cover is ₦100,000, roadside-to-hospital ambulance is included three times per annum, and the disability and death benefit rises to ₦250,000.
4.

HyPrime Plus (₦480,380 per annum) : HyPrime Plus opens access to Category A through D hospitals with an inpatient limit of ₦600,000 in a private ward for up to 20 days per annum and surgeries up to ₦250,000. The outpatient limit is ₦300,000, chronic medication ₦85,000, and advanced investigations are covered once per annum. Maternity cover is ₦100,000, unlimited telemedicine and roadside ambulance are included, and the disability and death benefit is ₦250,000. This tier suits enrollees who want private-ward comfort and top-category hospital access.
5.

HyPrime Exclusive (₦748,660 per annum): HyPrime Exclusive is Hygeia's most comprehensive standard individual plan, with Category A through D access, an inpatient limit of ₦3,000,000, and an outpatient limit of ₦1,500,000. It covers minor, intermediate, and major surgeries including endoscopies up to ₦600,000, treatment of chronic conditions, maternity and neonatal services up to ₦300,000, and a private ward for up to 20 days per annum. Physical and virtual GP and specialist consultations, dental care, ENT care, optical care, annual health checks, telemedicine, and nutritionist cover are all included.
6.

Senior Midi (₦230,000 per annum): The entry point to Hygeia's senior range for older enrollees, Senior Midi covers Category C and D hospitals with an inpatient limit of ₦1,000,000 in a general ward for up to 30 days per annum and surgeries up to ₦250,000. The outpatient limit is ₦350,000 with GP and up to 12 specialist consultations per annum, unlimited telemedicine, and doctor home visits. Chronic disease medication is covered, cancer care and a death and funeral benefit of ₦100,000 are included, dental care is ₦30,000, and ENT treatment and surgeries are covered. Maternity is not included on the senior plans.
7.

Senior Mini (₦452,760 per annum) : Senior Mini builds on the Senior Midi structure for older enrollees who want a higher service tier, retaining Category C and D access with an inpatient limit of ₦1,000,000 in a general ward for up to 30 days per annum and surgeries up to ₦250,000. The outpatient limit is ₦350,000, with unlimited telemedicine, doctor home visits, chronic medication cover, cancer care, a death and funeral benefit of ₦100,000, dental care up to ₦30,000, and ENT treatment and surgeries.
8.

Senior Premium (₦900,000 per annum) : Senior Premium steps senior enrollees up to Category A through D access with an inpatient limit of ₦3,350,000 in a private ward for up to 30 days per annum. The outpatient limit is ₦1,350,000, advanced investigations are covered for up to 8 sessions, and optical care including frames, lenses, and contact lenses is covered up to ₦40,000 per annum. Dental care is ₦80,000, cancer care and a death and funeral benefit are included, and physiotherapy and intensive care services are covered.
9.

Senior Exclusive (₦1,115,000 per annum) : Hygeia's most comprehensive senior plan, Senior Exclusive gives unrestricted access to Category A through D providers with additional access to premium facilities including Evercare Hospital and Reddington Hospital. The inpatient limit is ₦3,350,000 and the outpatient limit is ₦1,650,000, with a private ward for up to 30 days per annum and surgeries including endoscopies up to ₦1,000,000. Treatment of chronic conditions including senile cognitive disorders, dental, ENT and optical care, cancer care, a death and funeral benefit, and intensive care services are all included.

Who Should Consider This

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1.

Budget-conscious individuals who want to control cost through hospital category. : Hygeia's category-based structure lets you match your premium to the tier of facility you want to use, from HyEase at the entry level to HyPrime Exclusive at the top.
2.

Young families:: HyEase, HyBasic, and the HyPrime tiers include antenatal care, normal delivery, postnatal care, and NPI immunisations for children aged 0 to 5, which makes them a practical choice for parents planning.
3.

Older enrollees:: Hygeia is one of the few Nigerian HMOs with a dedicated senior range. The Senior plans include chronic medication, cancer care, doctor home visits, and a death and funeral benefit tailored to the needs of older enrollees.
4.

High-income earners: : HyPrime Exclusive and Senior Exclusive combine multi-million-naira inpatient limits, private-ward access, cancer care, and access to premium facilities for those who want minimal gaps in cover.

nairaCompare Insight

Hygeia HMO's clearest strength is choice. Few Nigerian HMOs offer a nine-plan individual range that runs from an affordable entry tier all the way to premium comprehensive cover, and even fewer maintain a separate set of plans built specifically for senior enrollees. The category-based design means you are not only choosing a benefit limit, but you are also choosing the standard of hospital you can walk into, which is a useful lever if you already have preferred facilities in mind.

For most working Nigerians, HyPrime represents the most balanced entry into meaningful cover, offering semi-private ward access, chronic medication support, and advanced diagnostics at a premium that remains accessible. What stands out at the top of the range is the Senior Exclusive plan's access to premium facilities such as Evercare and Reddington alongside cancer care and cover for senile cognitive disorders, benefits that many individual plans exclude. Use nairaCompare to weigh Hygeia's category tiers and limits against other providers before deciding.

About Hygeia HMO

Hygeia HMO is one of Nigeria's leading health insurance and medical aid providers, operating since 1986 and regulated by the National Health Insurance Authority. The company provides comprehensive access to healthcare for individuals, families, and businesses through an accredited network of hospitals, clinics, pharmacies, dental, and optical centres across the country. Hygeia HMO is Nigerian-run and is backed by notable global shareholders including the International Finance Corporation, part of the World Bank Group.

CONTACT ADDRESS ConSol House, ConSol Close, Plot C, Block 2, Ilupeju Industrial Estate, Oshodi-Apapa Expressway, Lagos

WEBSITE www.hygeiahmo.com

PHONE NUMBER 0700-494342-466

EMAIL ADDRESS hycare@hygeiahmo.com

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