Ultimate Health HMO Launches GIFSHIP: Affordable Health Insurance for Nigerians

For decades, Nigerians have struggled with the burden of healthcare costs, often facing financial ruin when illness strikes. Ultimate Health HMO has launched GIFSHIP, the Group, Individual, and Family Social Health Insurance Programme, designed to make quality healthcare affordable, accessible, and equitable for all.

Nigeria’s healthcare system has faced inadequate funding, poor infrastructure, and lack of access to quality care. GIFSHIP, regulated by the National Health Insurance Authority (NHIA), offers coverage for primary, secondary, and tertiary healthcare services at a premium of ₦38,718 per person per annum. This aligns with broader economic pushes like Nigeria's research and innovation funding.

Launch Event and Key Statements

At a press briefing in Lagos, Managing Director/CEO Otunba Lekan Ewenla emphasized shifting from assumptions to action, citing the 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.”

“The GIFSHIP package is a strategic step to strongly focus on the objectives of making healthcare affordable, accessible, and equitable,” Ewenla said. The package caters to individuals, families, groups, and corporate organizations, targeting the mass market.

“This is a game-changer for Nigeria’s healthcare sector. 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 added. Similar regulatory vigilance is seen in financial consumer protection efforts.

NHIA Act 2022 and Regulation

The NHIA Act 2022 empowers the authority to approve and regulate private health insurance products. “The Authority shall ensure that health insurance is mandatory to every Nigerian and legal 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,” Ewenla noted.

GIFSHIP addresses past challenges like arbitrary premium reductions and varying benefit packages. It adopts the Health Risk Management Framework, with primary healthcare providers as risk managers at the primary level and HMOs at secondary and tertiary levels.

Health Risk Management Details

Capitation transfers health risk management at the primary level to providers, with 65% of the premium paid for a minimum actuarially recommended population of at least 2,500 enrollees. The capitation is paid to primary providers by the NHIA through HMOs. HMOs earn 10% of the public sector social health insurance premium as an admin fee, plus fee-for-service for defined healthcare services through pre-authorization codes issued by HMOs.

All challenges have been addressed by the NHIA Act 2022, Section 3. Healthcare providers are familiar with covered services at all three levels, the pre-authorization process, and NHIA tariffs for secondary and tertiary services. This structured approach supports financial planning akin to wealth-building strategies.

Call to Action

“We are changing the narration of our poor health indices, and we invite everyone to join us on this journey,” Ewenla said. Ultimate Health HMO has public sector enrollees and corporate organizations on board and targets the mass market to advance universal health coverage.

“We are targeting the mass market with GIFSHIP. 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.”