Before you start

Employment contract, for employer-arranged cover
CERPAC or residence evidence
Passport photographs and personal details for HMO enrolment
Vaccination records, including yellow fever

Step-by-step

1
Confirm what the employer's HMO plan actually covers
Plans vary widely in hospital panel, inpatient limits, maternity, chronic conditions and pre-existing exclusions. Get the schedule of benefits in writing rather than the brochure, and check the named hospitals against where you live and work.
Via employerWho: YouWeek 1
2
Register at your primary provider before you are ill
HMO plans in Nigeria route you through a designated primary provider who refers onward. Register in person, get your card or code, and confirm the process for after-hours and emergency presentation. Doing this cold at 2am is the wrong time to learn it.
In personWho: YouWeek 2
3
Arrange an evacuation or international policy separately
Most employers of foreign staff in Lagos carry a medical evacuation policy. Confirm whether yours does, what triggers it, and which number you actually call. It is a separate product from the HMO and the two are frequently confused.
Via employerWho: You
4
Get malaria prophylaxis advice and a testing habit
Malaria is endemic and year-round in Lagos. Long-term residents generally stop taking prophylaxis and instead test early and treat fast; short-stay arrivals normally take it. Get the advice from a Lagos clinician rather than a travel clinic abroad, and keep rapid tests at home.
In personWho: You
5
Check vaccinations beyond yellow fever
Yellow fever is the entry requirement, but typhoid, hepatitis A and B, meningitis and rabies are commonly recommended for residents. A Lagos travel and vaccination clinic can complete the set locally.
In personWho: You
6
Keep a personal emergency plan written down
Which hospital, which route at rush hour, which ambulance service, which number, and who at work holds a copy. In a city where a ten-kilometre journey can take an hour, the plan is the useful part rather than the insurance card.
In personWho: You

Documents you’ll need

HMO card or enrolment code
Schedule of benefits from the plan
Evacuation policy details and its emergency number
Vaccination card including yellow fever
List of current medications with generic names

Things most newcomers don’t know

Health insurance in Nigeria became a legal obligation in 2022, and many employers still treat it as a perk.

The National Health Insurance Authority Act 2022 replaced a voluntary scheme with a mandatory one, covering all Nigerians and legal residents and requiring employers with at least five staff to enrol their employees. If an offer letter is silent on health cover, that is a question to raise rather than a gap to accept — the obligation is on the employer, and the fact that enforcement is uneven does not change what you are entitled to ask for.

Source: National Health Insurance Authority Act 2022

Which hospital your plan lists matters more than the level of cover.

Lagos has excellent private hospitals and the gap between the best and the average is wide. HMO plans work off a named panel, and being routed to a facility an hour away through Lekki traffic is a materially worse outcome than the same benefit level at a hospital ten minutes from your flat. Read the panel list against a map of your actual life before accepting a plan, and ask whether an upgrade to a wider panel is available.

Source: community-reported

Long-term residents treat malaria as a testing problem, not a prophylaxis problem.

Transmission in Lagos is year-round and continuous prophylaxis over years carries its own costs, so most established residents stop taking it and instead keep rapid diagnostic tests at home, test at the first fever and treat immediately with artemisinin-based therapy. That approach depends on testing early and having medication to hand. Newly arrived people who assume a fever is jet lag lose two days, which is the part that turns an ordinary illness into a hospital admission.

Source: community-reported

Medical evacuation cover and HMO cover are different products and people confuse them.

An HMO plan pays for treatment at Nigerian hospitals on its panel. An evacuation policy flies you out to South Africa, Europe or the Gulf when the required care is not available locally. They are sold separately, triggered differently and have different phone numbers. Knowing which one you actually hold — and which number to call — is a five-minute check that people only make once it is too late to make it calmly.

Source: community-reported