FG doubles health insurance payment, introduces one-hour patient referral code

The federal government has increased the health insurance capitation fee for enrollees from N750 to N1,450 per person, in a move aimed at improving access to quality and affordable healthcare.

Ali Pate, coordinating minister of health and social welfare, announced the increment in a statement on Saturday, noting that the adjustment supports President Bola Tinubu’s Renewed Hope Agenda and Nigeria’s goal of achieving universal health coverage by 2030.

Capitation refers to the fixed amount paid to healthcare providers for each patient registered within a specific period.

Pate said the fee-for-service rates have also been reviewed upward by 380 percent to reflect current costs and enhance service delivery standards.

“For years, the capitation stood at N750 per person. We have doubled it to N1,450 to ensure providers are properly equipped to deliver consistent, high-quality care,” he said.“Fee-for-service rates have also been increased by 380%, based on actuarial evidence aligning cost-reflective rates with quality requirements.”

The minister disclosed that over 2.4 million Nigerians were newly enrolled in 2024, bringing total coverage to about 20 million people, with projections to reach 44 million by 2030. He added that nearly 120,000 health workers have been trained since 2023, while 2,500 doctors, nurses, midwives, and community health extension workers have been recruited to strengthen frontline services. Another 4,000 health personnel, he said, have joined federal tertiary hospitals to address workforce shortages.

“Out-of-pocket payments still account for about 70 percent of health spending. Expanding insurance coverage is the surest way to reduce this burden,” Pate noted.

To further improve efficiency, the minister said the government has introduced a one-hour referral authorisation code to reduce delays in moving patients from primary to specialist care. He also directed the National Health Insurance Authority (NHIA) to commence covert “mystery shopping” exercises to monitor healthcare facilities and ensure enrollees receive timely treatment.

According to him, ongoing reforms under the Basic Health Care Provision Fund (BHCPF) and the NHIA are restoring public confidence and encouraging more Nigerians to adopt health insurance.