private health insurance

Here is the backwards part. Nigeria does not have a national health service that calmly pays your hospital bills the way the UK's NHS does, so many people assume private health insurance is a luxury for the rich. But flip it around and you will see it is actually the opposite of a luxury. It is the thing that stands between an ordinary family and a medical bill that can wipe out years of savings in one week.

Here is how it works. You pay a premium, monthly or yearly, to an insurer such as Hygeia or Reliance HMO. In exchange, they promise to pay for a list of medical services when you need them, from malaria treatment to surgery to maternity care, depending on the plan you chose. You are not paying for sickness. You are paying so that sickness, if it comes, does not also come with financial ruin.

Think of Adaeze in Lagos, who pays her HMO ₦180,000 a year through her employer's group scheme. When her son needed an emergency appendix operation, the hospital bill came to ₦650,000. Adaeze paid nothing beyond her card at the gate, because the HMO settled it directly with the hospital. Without that plan, she would have been calling relatives at midnight trying to raise cash while her son waited on a trolley.

In the UK, someone might already have the NHS for free treatment, but they still buy private health insurance through work or personally, mainly to skip long waiting lists for things like knee surgery or to get a private room. It is less about avoiding cost and more about avoiding delay.

For Nigerians abroad sending money home, this is worth knowing too. Some now pay for a parent's HMO plan in Lagos or Enugu directly, the same way they might pay a school fee, because a working health plan for mum and dad can matter more than a one time cash gift when the emergency actually arrives.