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Complaint & Enquiry

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The Scheme
Refers to National Health Insurance Scheme (NHIS). A corporate body established under Act 35, of 1999, to regulate and provide health insurance in Nigeria
Enrollee or Beneficiary
A person who has enrolled (or has been enrolled) with NHIS.
Principal Enrollee
A person on behalf of whom the other biological members of the family (dependants) are enrolled.
The spouse and children of a principal enrollee.
Primary Health Care Provider (PHCP)
Is the entry point and point of first contact of an enrollee with a healthcare provider.
Primary Care Provider
Same as in PHCP.
Secondary Health Care Provider
Refers to Health Care Provider which offers specialized services to patients referred from the primary healthcare provider.
Tertiary Health Care Provider
Refers to Health Care Provider which offers highly specialized services based on referral from secondary care level.
Alternative Primary Health Care Provider
Is the PHCP selected by dependant(s) who is not resident in the same location with the principal.
Health Maintenance Organization (HMO)
A private or public incorporated Company registered by the NHIS solely to manage the provision of health care services through Healthcare Providers accredited by the Scheme.