FG Doubles Health Insurance Payout to N1,450, Introduces Patient Referral Code for Improved Care

The Federal Government has announced a significant increase in the health insurance capitation fee for enrollees, raising it from N750 to N1,450 per person. The move, according to authorities, is part of ongoing efforts to enhance the quality of healthcare delivery and expand access to affordable medical services across the country.

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Coordinating Minister of Health and Social Welfare, Professor Muhammad Ali Pate, disclosed the development in Abuja, explaining that the increase reflects the government’s commitment to strengthening the national health insurance system and ensuring better financial protection for Nigerians, particularly those in vulnerable groups.

Under the revised framework, the capitation fee—paid monthly to healthcare providers for each person enrolled in the health insurance scheme—will enable hospitals and clinics to offer more comprehensive services without excessive out-of-pocket payments by patients.

Pate stated that the adjustment aligns with current economic realities, the rising cost of medical supplies, and the government’s goal of achieving Universal Health Coverage (UHC). He added that the National Health Insurance Authority (NHIA) has been directed to implement the new rates immediately, ensuring that both public and private facilities under the scheme comply with the updated payment structure.

“This increase is not just about numbers; it is about improving service delivery. By adjusting the capitation rate, we are ensuring that healthcare providers have the resources they need to deliver quality care without unnecessary delays or shortages,” Pate said.

In addition to the new rate, the government has also introduced a “Patient Referral Code” system designed to improve patient tracking, accountability, and coordination within the national healthcare network. The referral code will accompany every enrollee who moves between healthcare facilities, ensuring that medical history, treatment details, and referral records are seamlessly shared among providers.

According to the Minister, the digital referral code will reduce duplication of services, minimize fraud, and ensure that patients receive timely care at the appropriate level of the healthcare system—whether primary, secondary, or tertiary.

The initiative forms part of a broader reform under the Health Sector Renewal Investment Programme, which aims to digitize healthcare processes, expand insurance coverage to informal sector workers, and strengthen collaboration between federal and state health authorities.

Healthcare professionals and insurance administrators have welcomed the policy, describing it as a “timely intervention” that could help stabilize the system amid rising costs of pharmaceuticals and medical consumables.

Dr. Emmanuel Meribole, Permanent Secretary at the Ministry, noted that the updated capitation rate was determined after extensive consultations with stakeholders, including health maintenance organizations (HMOs), hospitals, and professional associations.

He emphasized that the new structure would ensure that providers are adequately compensated, thereby improving staff motivation, patient satisfaction, and overall system efficiency.

The NHIA has also been tasked with monitoring implementation to prevent abuse and ensure that the increased payments translate into measurable improvements in patient outcomes. The agency will deploy digital monitoring tools and conduct periodic reviews to assess performance across all participating facilities.

Pate reiterated that the reforms are part of President Bola Ahmed Tinubu’s administration’s Renewed Hope Agenda, which prioritizes human capital development through stronger healthcare, education, and social welfare systems.

He assured Nigerians that the government remains committed to building a resilient health system that leaves no one behind, particularly the poor and vulnerable who rely heavily on public healthcare financing mechanisms.

“We are taking deliberate steps to make health insurance work for everyone—whether you live in the city or a remote village,” Pate added. “This adjustment will empower facilities to deliver better services, reduce waiting times, and make health coverage truly meaningful.”

With the new measures in place, stakeholders say Nigeria is moving closer to its goal of ensuring that every citizen has access to affordable and reliable healthcare services without suffering financial hardship.

The NHIA is expected to roll out further guidelines and awareness campaigns to educate enrollees and providers on how to access the new capitation benefits and use the referral code effectively.