State health insurance schemes in Nigeria

Checked 18 October 2026 against agency websites, state government pages and Nigerian press. Agencies rename and laws are amended: confirm with the agency before relying on any detail. Spotted an error? Email hello@naijahealth.ng.

What this means for hospitals

A Nigerian private hospital can be empanelled under NHIA, under its state scheme and with several HMOs at once. Each has its own eligibility check, tariff, referral rules and claims format, and in states where enrolment is mandatory the insured share of patients keeps rising. The practical requirement is a patient record that holds each person’s scheme or HMO number and a billing process that can invoice each payer correctly. Our guides on NHIA billing and claims, capitation versus fee-for-service and the BHCPF cover the national side.

Frequently asked

Does every Nigerian state have a health insurance scheme?

Yes. All 36 states run a state-supported health insurance agency or scheme. The FCT runs the FCT Health Insurance Scheme through the FCT Administration, but as of April 2026 the bill giving it a statutory agency was still awaiting presidential assent.

Which states have mandatory health insurance?

9 states describe enrolment as mandatory for all residents: Lagos, Kwara, Niger, Delta, Edo, Akwa Ibom, Imo, Zamfara and Bauchi. 5 make it mandatory for public servants, and in 3 (Cross River, Enugu, Anambra) the law makes it compulsory but enforcement has not started in full. The rest run contributory schemes.

How do state schemes relate to NHIA?

The National Health Insurance Authority Act 2022 makes health insurance mandatory nationally and has states run their own schemes for residents, with NHIA accrediting and regulating. A hospital can be empanelled under NHIA, under one or more state schemes and with private HMOs at the same time, each with its own enrolment checks, tariffs and claims.

What does this mean for a private hospital?

If your hospital is empanelled under a state scheme, you verify each enrollee's eligibility, record their scheme number, follow the scheme's tariff and referral rules and submit claims in its format. Hospitals in states with mandatory schemes, such as Lagos under ILERA EKO, should expect a growing share of insured patients and closer checks on their records.