In Nigeria, access to healthcare is one of the most unpredictable aspects of everyday life. Public hospitals are underfunded. Private clinics are expensive. And even the best-laid health insurance plans can collapse under bureaucracy or poor service.
Beginning around the mid-2010s, the sector saw the entry and growth of tech-powered health maintenance organisations (HMOs) that improved access to timely and quality care. These companies, as well as older ones turning to technology to enable their service delivery, are reshaping what employer-sponsored healthcare looks like, and Human Resource (HR) professionals are taking notes.
I spoke to four HR professionals in Nigeria to find out which HMOs they trust, what makes them work, and where the system still fails. Their responses reveal what’s broken, what’s changing, and what’s actually worth paying for in Nigeria’s chaotic healthcare system.
What HR professionals prioritise in HMO plans
For HR professionals—Faith Emmanuel (8 years experience), Felix Bissong (7 months experience), Charity* (5 years experience), and Ebun* (3 years as a consultant)—the old metrics of price and “basic coverage” just don’t cut it anymore. More recently, professionals consider these three factors instead:
- Quick, reliable access to care: These HR professionals maintain that the ease and speed with which employees can access care from listed providers is crucial. “Delays frustrate employees and make them question the value of the plan,” Ebun says.
- Quality of service: For HR professionals, quality of service is non-negotiable. As Bissong puts it, “The peace of mind that comes with reliable service is worth more than cost.” Charity agrees: “If employees can’t access care because of poor service, the HMO ends up being underutilised [no matter] how affordable it is.” Emmanuel sums it up: “There are some mistakes money can’t fix, so it’s better they are prevented despite the cost [of the HMO]”. This includes access to specialists like Ear, Nose and Throat (ENT) doctors or gynaecologists, but also extras like optometry and wellness features. There’s also a growing employee expectation that plans come with telemedicine services, gym memberships, and access to real account managers, not just customer service lines that lead to dead ends.
- Affordable plans with no surprise out-of-pocket payments: HR staff want coverage that protects employees financially. They are clear on the fact that employees shouldn’t have to pay out of pocket for services their HMO is supposed to cover.
Three HMOs that get it right
These HMOs were named by Emmanuel, Bissong, Charity, and Ebun, who have tested them across companies and teams. They stand out, not just for popularity, but because they work, according to these professionals.
Reliance HMO
Reliance’s biggest strength is its tech, according to these professionals. The mobile app is intuitive, telemedicine support is responsive, and hospital approvals happen fast. HRs say this dramatically reduces complaints and absences resulting from sick days.
“I’ve used Reliance for my company and recommended it to clients,” says Ebun. “It’s reliable. Their mobile app works. Their doctors respond quickly. The whole experience just feels like it’s built for the user.”
Bridget Odo, a management engineer at First Primus, echoes this. As an employee, she says that before she arrives at the hospital, she can chat with an online doctor about her symptoms. “The registration process is smooth, and once I arrive, I don’t waste time. Their app is very easy to navigate,” she adds.
Leadway Health
Leadway isn’t new to insurance; it is one of Nigeria’s most established financial groups. While it may not have started out as a digital-first HMO like Reliance, HR professionals say it has adapted well to modern expectations, and praise Leadway for, among other things, managing new employee onboarding smoothly. Where other HMOs let names fall through the cracks, Leadway quickly resolves registration delays—a common pain point in Nigerian firms.
“Leadway Health is the most effective HMO I’ve used,” says Charity. “They are prompt in service delivery, have a wide network of reputable health facilities, and are well respected by hospitals. This ensures that employees receive timely and hassle-free treatment when needed.”
David*, a corporate communications officer at Globus Bank, adds that as an employee, he trusts Leadway because of its credibility. He adds that their pricing structure is affordable.
AXA Mansard
AXA Mansard stands out for its quality of service, according to Bissong. As part of the AXA Group, one of the world’s largest insurers, AXA Mansard is an older, more traditional player in the Nigerian HMO space. It may not be classified as a healthtech startup, but its scale and reliability still make it a top choice for HRs managing large teams. Employees under AXA’s plans also reported fewer service denials and better access to wellness benefits. HRs noted that AXA’s around-the-clock support and dedicated relationship managers make a noticeable difference, especially for large organisations.
Where the system still fails employees
Even with top-tier HMOs, many Nigerian employees still face frustrating issues. HR professionals spoke about the most common complaints they’ve heard from employees they have worked with. Here’s what came up:
- HMO plan expiration being claimed incorrectly.
- Prescribed medication not being dispensed by the hospital.
- Customer support lines not being answered.
- Hospitals being removed from HMO networks without notice.
These are all part of broader system-level failures. Poor data syncing, delayed updates, and fragmented communication between insurers and clinics result in real harm to trust, health, and morale.
Beyond coverage: What employees actually want
Different generations of workers value different services, but one thing is clear: they want more than emergency care. According to Charity, older staff focus on access to specialists. Younger ones care more about fitness, gym access, and general wellness. According to HR professionals, the following services are the most valued by employees:
- Full health checks
- Optometrist services: Eye care, including vision testing and access to recommended glasses
- Ear, Nose, and Throat (ENT) services
- Women’s health specialists
Choosing an HMO used to mean picking the cheapest plan that ticked basic boxes. Now, it’s about whether that provider can actually deliver a healthcare experience that employees trust and return to. It’s also about what technologies boost their services, be it a fast, intuitive mobile app, real-time customer support, or seamless integration with hospital systems.
In a sector where delay can be gravely consequential, the best HMOs buy time, clarity, and confidence.
*Name has been changed
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