International health insurance in Nigeria

IPMIAfrica explains how expats in Nigeria use international private medical insurance: where private hospitals are, how national health insurance applies, why evacuation abroad is central to the decision and what to check before you compare.

How healthcare works for expats in Nigeria

Nigeria has a large public health system run at federal, state and local level, and a private sector that ranges from small clinics to well-equipped hospitals. Public facilities are under heavy pressure, and most expats use private providers for everything from a GP visit to surgery.

Private hospitals of the standard an expat would expect are concentrated in Lagos, and to a lesser extent in Abuja and Port Harcourt. Several can handle routine surgery, maternity, diagnostics and stabilisation of serious cases. For complex treatment such as cancer care, cardiac surgery or specialised paediatrics, many expats and wealthier Nigerians still travel abroad, usually to the United Kingdom, Europe, South Africa, India or the Gulf.

An expat can in theory use public hospitals, but in practice the gap between public and private is wide enough that very few do. Private hospitals expect payment at the point of care unless they have a billing arrangement with your insurer, and deposits before admission are common.

National health insurance and the rules to check

Nigeria has national health insurance legislation that is intended to make health insurance compulsory for residents over time, with implementation phased in and managed through a national authority and state schemes. In practice the scheme is aimed at citizens and residents and provides access to a defined package of care through accredited providers. It is not designed to pay for private hospitals of the standard most expats use, and it does not cover treatment abroad.

• If you are employed in Nigeria, ask your employer whether contributions are made on your behalf and what that entitles you to.
• Many employers provide a local group plan through a health maintenance organisation. Find out which hospitals are in its network, what the limits are and whether evacuation is included.
• Nigeria does not, as far as we are aware, require international health insurance for a visa or work permit, but expatriate quota and permit rules change. Confirm the current requirement with your employer, the immigration authority or an adviser.

None of this prevents you holding an international plan. Most expats in Nigeria hold one precisely because local arrangements do not cover the scenarios they worry about most.

Why expats in Nigeria choose international cover

Nigeria is one of the clearest cases for international health insurance anywhere in Africa. The reasons expats give are consistent.

• Treatment abroad. The plan pays for care outside Nigeria when it is not available locally, including in your home country if your area of cover includes it.
• Evacuation. Air evacuation from Lagos or Abuja to Europe, South Africa or elsewhere is expensive. The benefit, and the assistance company behind it, is the core of the plan.
• Higher limits. International plans are built for serious, costly events in expensive hospitals abroad. Local plans usually are not.
• Portability and renewability. Oil and gas, banking, telecoms and diplomatic postings move on. The plan moves with you and renews for life.

Travel insurance is for short trips and emergencies only. It is not a substitute for living in Nigeria for years.

Evacuation and repatriation from Nigeria

In Nigeria, evacuation is not an edge case. For many serious conditions the right treatment is abroad, so the plan's evacuation benefit is the mechanism that gets you there. Read it closely.

Check whether evacuation is to the nearest appropriate facility, which may be within Nigeria, or whether it extends to another country when the treatment is not available locally. Check whether it covers a companion and a return flight. Check who decides: almost all plans require the insurer's assistance team to agree the medical need and arrange the transport, and will not reimburse an evacuation you arranged yourself. And check whether the plan excludes evacuation from areas subject to travel advisories, since parts of Nigeria are covered by such advisories and some wordings respond to that.

Repatriation, the return home once you are stable or the return of remains, is a separate line and is worth confirming. Many expats in Nigeria also hold a standalone evacuation membership through an employer. Make sure you know which policy responds first and whether either requires pre-authorisation. Our evacuation guide goes through the wording in detail.

The decisions that change the cover

Pre-existing conditions and underwriting

Insurers handle medical history through full medical underwriting, where you declare everything and get a written decision up front, or through a moratorium, where recent conditions are excluded for a set period and may become covered if you remain symptom free. If you already hold international cover, ask about switch terms or continued personal medical exclusions so that you keep the underwriting you already have. Our pre-existing conditions guide sets out the options.

How to prepare a comparison

Before quoting, decide where you want to be treated for a serious condition, who needs cover, which benefits are essential and what excess you could absorb. That answers the area-of-cover question, which drives most of the rest.

The IPMIAfrica insurer pages explain each plan's structure. For Nigeria, expats most often compare Cigna Global, Allianz Care, Bupa Global, AXA Global Healthcare, IMG Global and VUMI Global. The Cigna vs IMG comparison is a useful place to start. For how premiums vary by country, the HealthiNomad Premium Index publishes an independent table.

Frequently asked questions

This page is general information, not personal or medical advice. Prices are indicative and confirmed by the insurer at underwriting. For advice on your situation, speak to an experienced broker.