How to Change Your HMO in Nigeria (Without Losing Cover)

Unhappy with your HMO? Maybe your hospital keeps refusing your card, approvals take too long, or your plan no longer fits your family. You can change your HMO in Nigeria, but timing and preparation matter, so you don’t end up with a gap in cover or new waiting periods at the wrong time.

This guide explains when you can switch, the steps to follow, and what to watch out for.

Can I change my HMO?

Yes. If you buy your own plan, you can move to another HMO accredited by the National Health Insurance Authority (NHIA) by ending your current contract and starting a new one. The smoothest time to switch is at renewal.

If your health plan comes through your employer, the employer chooses the HMO. Speak to HR about your concerns. Many companies review their HMO every year, and staff feedback often drives a change.

Good reasons to change your HMO

• Your preferred hospital has left the network, or there are no good hospitals near you
• Approvals (authorisation codes) are slow, so you wait at the hospital
• Claims or reimbursements are delayed or refused without clear reasons
• It is hard to reach customer support, especially in emergencies
• Your needs have changed, for example marriage, pregnancy plans, a new baby or a new chronic condition
• You are paying for benefits you don’t use, or missing benefits you need

How to change your HMO: step by step

1. Check your current plan. Note your renewal date, any notice period for cancelling, and whether any premium is refundable.
2. Compare HMOs. Look at NHIA accreditation, hospitals near your home and office, benefit limits, waiting periods, exclusions and price. See how to compare HMOs.
3. Read the full benefits and exclusions, not just the brochure.
4. Declare any pre-existing conditions to the new HMO in writing. Leaving them out can lead to refused claims later. Learn about pre-existing conditions (PEC).
5. Time the switch. Ask the new HMO to start your cover the day after your current plan ends, so there is no gap.
6. Cancel your old plan in writing and ask for written confirmation of your last day of cover.
7. Activate your new plan. Download the HMO’s app, check your hospital list and save the support number before you need it.

What to watch out for when switching

Waiting periods start again. Each new plan has its own waiting periods for some benefits, such as surgery, maternity and specialist care. Benefits you had unlocked with your old HMO do not carry over.

Pregnancy. If you are pregnant or planning to be soon, switching can mean losing maternity cover because of new waiting periods. It is usually better to stay with your current plan until after delivery, if it covers maternity. See does HMO cover pregnancy?

Ongoing treatment. If you are in the middle of treatment or have a claim in progress, settle it with your current HMO before you switch.

Gaps in cover. Never cancel your old plan before the new one is active.

Annual limits and loyalty benefits do not transfer to a new HMO.

What if your problem can be fixed without switching?

Sometimes a quick call solves the problem. You can often:

• Change your primary hospital to one closer to you
• Upgrade to a plan with more hospitals or higher limits
• Add family members to your plan
• Escalate a complaint to a supervisor

If a complaint is still unresolved, you can report an NHIA-accredited HMO to the NHIA.

Switching to Reliance HMO

If you’re thinking about switching, Reliance HMO offers access to over 2,700 hospitals and other providers across Nigeria, 24/7 doctor chats in the Reliance Care app, and prescription delivery. Download it for iPhone or Android. Businesses can choose small business plans or company health plans, and families can explore plans through Alafia by Reliance Health.

Frequently asked questions

How often can I change my HMO?
If you buy your own plan, you can change at the end of your plan period or when your contract allows. Check your contract’s cancellation terms.

Can I change my HMO if my employer pays for it?
Your employer chooses the HMO for company plans. Raise your concerns with HR, or buy an extra personal plan if you want different cover.

Will I lose my benefits if I switch HMOs?
You may face new waiting periods and your annual limits will start again with the new HMO. Plan the timing carefully.

Can I switch HMOs while pregnant?
You can, but new maternity waiting periods mean you may not be covered for antenatal care or delivery. It is usually better to switch after delivery.

Information is general and may change. Check the terms of your current and new plans before switching.

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