Health Insurance Survey
The National Health Insurance Scheme (NHIS) in Nigeria aims to provide health insurance to individuals by ensuring that insured persons and their dependants have access to good quality and affordable healthcare services. However, results from past studies have demonstrated customer dissatisfaction with the service for reasons such as being charged additional fees on the pretext of non-inclusion of particular services in their insurance plan and poor customer service. It has also been discovered that there is poor general knowledge of the service among the enrolled. This study therefore aims to assess the perception of health insurance amongst Nigerians and to evaluate the quality and preference of Health Maintenance Organisation services provided to them.
This study was administered through online questionnaires. A total of 2,084 responses were received and analysed.
The major findings of this study are as follows:
- Enrolment to Health Insurance
51% of the total number of respondents do not have health insurance, comprising 44% who pay out-of-pocket for medical treatment at a hospital and 7% who self-medicate.
The remaining 49% have health insurance. Enrolment to the service is strongest in those who are employed (96%), married (70%) and those who earn above N100,000 monthly.
On the other hand, the majority of respondents who do not have health insurance are mostly single (70% for self-medicators and 48% for those who pay out-of-pocket), employed (64% for self-medicators and 64% for those who pay out-of-pocket) and earn below N100,000 monthly.
- Demand for Health Insurance
Of the total number of respondents, 77% indicate they have sought medical attention from a healthcare professional within the past year while 23% have not. Majority of those who have sought medical care in the past year (55%), have health insurance.
Over 80% of respondents who do not currently have health insurance would like to have the service regardless of whether they self-medicate or pay out-of-pocket for medical treatment at a hospital.
- Reasons for Obtaining Health Insurance
Of the total number of those who have health insurance, most indicated they enrolled for the service because it was part of their employment package (53%) while the least cited reason was the provision of peace of mind for the customer (9%).
For those who do not have health insurance, the most cited reason for not enrolling was because their employer does not pay for the service (30%). Another 15% indicated they had no knowledge of the scheme in Nigeria. The least cited reason for not getting health insurance was the refusal by HMOs to provide cover for patients with certain preexisting health conditions (2%).
- Correlation between Source of Funding and Customer Satisfaction Levels with quality of service
Employers provide the funding for the majority of respondents (89%) with health insurance while the remaining 11% fund their insurance themselves.
Employer-paid health insurance did not appear to be a guarantee of better satisfaction with the service. According to this survey, self-funded respondents are statistically more satisfied with the service (63%), than those on employer-funded health insurance (62%), although the margins are very fine indeed.
Although over 80% of respondents with health insurance intend to renew their plans on expiration, about 60% of those on employer-funded insurance will do so only because it is required by their employer. If given the option, they state that they would cancel the plan or change to a different HMO.
- How Customers rate HMO services
The HMO with the highest number of enrolled respondents was Hygeia HMO Limited (23%). The main reason given by respondents for their choice of HMO was employer’s choice (50%).
Respondents indicated that the biggest advantage (45%) of using a HMO is the decreased out-of-pocket costs for medical treatment that arise as a result. The biggest disadvantage indicated was the restrictive nature of the services provided (23%).
Respondents also suggested ways through which HMOs could provide better services. These included increasing coverage of treatments/services provided, reduction in hospital waiting times, providing better quality drugs, follow-up care, routine check-up and better customer service…