Health Insurance Plans That Cover Surgery and Hospitalization in Nigeria

Nobody ever plans to fall seriously ill or need surgery, yet it happens every single day. And when it does, hospital bills can drain your savings within hours. That’s why health insurance plans that cover surgery and hospitalization have become essential for individuals and families across Nigeria.

From appendectomies to emergency cesarean sections, surgeries aren’t just expensive—they’re often urgent. If your insurance doesn’t include inpatient treatment, operating theatre fees, anesthesia, specialist consultations, and post-op care, you could be left stranded at the worst possible time. Here’s the full picture of what you should be looking for if you want a health plan that truly protects you when hospitalization or surgery becomes unavoidable.

What’s Usually Included in Hospitalization and Surgical Coverage?

When you choose a health plan that includes hospital admission and surgery, here’s what you can typically expect:

• Pre-surgical consultations and diagnostic tests
• Emergency and elective surgeries (some plans exclude cosmetic or elective procedures)
• Inpatient care including hospital bed, feeding, and nursing
• Theatre and anesthesia costs
• Specialist consultation and follow-up treatment
• Post-surgical care such as wound dressing and physiotherapy

Some advanced plans may even include ICU (intensive care unit) access, maternity-related surgeries like C-sections, and oncology-related surgeries.

But here’s the twist—not all health plans that claim to offer “hospitalization cover” are fully loaded. That’s why you must read the benefit schedule and ask the provider specific questions before you pay a kobo.

Who Offers These Plans in Nigeria?

Several Health Maintenance Organizations (HMOs) and insurance firms offer plans that cover surgery and hospital stays. But not all plans are equal.

In Lagos, Abuja, Port Harcourt, and major cities, insurers like Hygeia HMO, AXA Mansard, Avon HMO, Leadway Health, Reliance HMO, and Total Health Trust have designed plans that cover hospital admissions, minor and major surgeries, and extended inpatient treatment.

Some corporate packages offer more generous benefits than individual or retail plans, but individual options are catching up. For example, AXA Mansard’s “Platinum” or “Premium” plans include comprehensive surgical cover, while Hygeia’s Gold plan supports major procedures with hospitalization in top private facilities.

What You Should Check Before Committing

Many people only realize the limitations of their health plans when it’s too late—usually when a hospital refuses to carry out a procedure because it’s “not covered.” To avoid this mess, always ask these questions before enrolling:

• Are both emergency and elective surgeries covered?
• Which hospitals can I access for surgical procedures?
• Are specialist fees included in the cover or billed separately?
• What are the hospitalization limits per year or per illness?
• Are there exclusions, such as plastic surgery, weight-loss surgery, or certain types of cancer-related surgeries?

Also, check for the plan’s cap on hospital admission days. Some plans limit inpatient care to 15 or 30 days per year unless you upgrade to a premium tier.

How Much Do These Plans Cost?

Pricing varies based on age, health condition, provider, and plan type. For individual plans:

• Basic hospitalization cover with limited surgery access may cost ₦30,000–₦60,000 per year.
• More inclusive packages with full inpatient and surgical coverage can cost ₦80,000–₦150,000 or more annually.

Family plans tend to be cheaper per person and may fall within the ₦100,000–₦300,000 range depending on the number of dependents. Some providers now offer monthly payment options ranging from ₦5,000 to ₦15,000. However, the higher your monthly premium, the broader your surgical and hospitalization benefits.

Which Hospitals Accept These Plans?

This depends on the HMO or insurer’s hospital network. The best insurers have wide networks that include top-tier private hospitals and specialists in major cities. Always request a current list of partner hospitals and confirm if your preferred facilities accept the plan. Even better, call the hospital directly and verify that they accept patients on that specific package.

Are There Waiting Periods?

Yes. Most plans have a waiting period for surgeries that are not emergencies. For example:

• Elective surgery: 3 to 6 months after enrollment
• Maternity-related surgeries: 9 to 12 months
• Pre-existing conditions requiring surgery: may be excluded for the first year

Emergency surgeries—such as those needed after a road accident or sudden health crisis—are usually covered immediately once your plan is active. But always read the fine print.

Real-Life Benefits of Getting Covered

Imagine being rushed to the hospital with acute appendicitis and needing emergency surgery. A plan with hospitalization and surgical cover will save you from dropping hundreds of thousands instantly. Or picture a scenario where your child needs a hernia repair, or your elderly parent requires cataract surgery. With the right cover, you won’t have to beg for funds or delay the procedure. Even routine procedures like gallbladder removal or fibroid surgery can be accessed more confidently when you know the costs are covered.

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