Our Services

Private Health Insurance Scheme (PHIS)

Private Health Insurance Scheme (PHIS) is designed for corporate organizations, small-medium enterprises (SMEs) and private individuals.

The Health Plan is sold at an actuarially determined amount called the premium.

PROHEALTH HMO has three (3) main plans under the Private Health Insurance Scheme (PHIS) as listed below:

  1. PROHEALTH Diamond
  2. PROHEALTH Pearl
Outside  the   Health  Plans    above,  we    underwrite  customized healthcare benefit plans for institutions and individuals on request.

PHIS Features


The  premium on  each of  the PROHEALTH plans is actuarially determined considering the medical benefits for the health plan. The premium is payable in advance to PROHEALTH HMO for  a policy  period of one year,  renewable upon the payment of a new premium.


Waiting period for new enrolment is 10working days and access to healthcare benefits commences after 10  working days  for  new enrolment. This is to enable conclusion of all enrolment processes.


Enrolment could be for group, family and individual policy. The family or individual is the unit of registration.


Where an organisation subscribe to the Health Insurance Policy on behalf of its  employees, the group would be  registered with the organisation’s legal name and its employees registered under the group.

A group policy is a pool with a minimum of ten (10) principals registered under the scheme. The principals can be on family or individual plan.


The standard regulatory requirement for  a family  cover  is the principal, the spouse, and a  maximum of  four (4) biological children under the age of 18years. Under a family plan, there is an expected variation in the household sizes but by principle, a family  enrolment is expected to pay  the full rate for  a family plan regardless of the size at the time of subscribing to the scheme. There is room for addition of dependant as the family size increases.

Grandchildren, siblings, parents and grandparents are  NOT eligible dependants under a family  plan.

A child  or  other dependant(s) not covered under the family  plan can  be enrolled as an individual under the scheme.

ProHealth could adopt a flexible underwriting rule for family composition in a large group to meet client’s unique composition.

Any child above 18 years not covered under a family plan can be registered on individual plan.


An individual can subscribe to our individual plan.

Additional child  above the covered four dependants in a family  plan can  be registered on individual plan. However, the child must be three (3) months of age or older to be eligible for a child-only plan for individual.


A Medical Service Agreement outlining the terms and condition of the Health Insurance Policy would be executed between ProHealth HMO and the client for every policy.

Community Based Social Health Insurance Scheme (CBSHIP)

Community Based  Social  Health Insurance is a  non-profit health insurance programme for a cohesive group of households / individuals or homogenous occupation based groups, formed on the basis of the ethics of mutual aid and the collective pooling of  health risks,  in  which members take part in  its management.

CBSHIP Features

  • Improves quality and access to basic health care services
  • Eliminates or  significantly reducing out-of-pocket  payment  for  health care services
  • Increases resources available for health care providers.
  • Improve  efficiency  in   the  allocation and  use   of   available  financial resources.
  • Creates awareness for  the benefit and importance of health care  among rural dwellers.
  • Ensures greater  coverage  and  access   to  healthcare at  minimal cost meeting the goal of universal coverage.
  • Provides avenue for  Health education, community efforts, medical advocacy, and awareness aimed at disease prevention, healthy living and elongation of life.
  • Involves all stakeholders in the management of the scheme and delivery of services.

Tertiary Institution Social Health Insurance Programme (TISHIP)

This is a social  health security system designed by National Health Insurance Agency (NHIA) to manage the health care needs of student in Tertiary Institutions.

The Premium is from funds pooled through the contribution of students.

The  scheme is  committed to ensuring access  to qualitative healthcare service   for  students, promotes healthy student lifestyle and conducive learning environment.

The scheme is run  through a Joint Committee for the Management of the scheme, comprising of representatives of the School Management, students’ representatives, the HMO and NHIS.

The School Management appoints the HMO to manage the scheme through the use of the school clinic as the Primary Health Care Provider and a chosen Secondary Health Care Provider.

The  benefits of  the scheme include optimum care  and health for  the students at all times and pooled funds for the school clinic.

Referrer: Where an ailment is beyond the medical scope of the clinic, the student will be referred to a secondary healthcare provider.

TISHIP applies to students of Tertiary Institutions: Universities, Polytechnics, colleges of education, schools of nursing and midwifery, monotechnics and other specialized colleges.

TISHIP Features

  • Prescribed drugs
  • Consultation with General Practitioners 
  • Health prevention and promotion 
  • Management of minor injuries
  • Management of sickle cell disease
  • Accidents and emergency
  • Deworming
  • Treatment of infections and infestations
  • Minor surgical procedures
  • Management of uncomplicated lower respiratory tract infection
  • Laboratory Investigations
  • Allergic conditions

Formal Sector Health Insurance Scheme

This is the mandatory National Health Insurance Scheme   for civil servants in the employments of Federal and State Governments. There is a standard health benefit package for all beneficiaries on the NHIS social health insurance scheme.


Other Health Insurance Schemes

Schools Social Health Insurance Programme (SSHIP)

This is a health insurance for the health coverage of primary and secondary school student when they are under the care and custody of their school

Urban Self-employed Social Health Insurance Programme


The scheme is design for the low income earners and self-employed entrepreneurs. The scheme is to cater for financially viable self-employed Nigerians who are desirous of the opportunity to benefit from quality, affordable and cost reducing healthcare services.

The  scheme  provides  the  enablement  for  contribution  by  interested  persons irrespective of their socio economic background.

The contribution is remitted to a designated account to guarantee coverage for subsequent period of the policy

Retiree Health Insurance Programme (RHIP)

The scheme is for the elderly in the society

The benefits are targeted at meeting health care need peculiar to old age

The scheme is best suitable for people who have retired from active service

Our Provider Network

ProHealth HMO has a wide range of Health Care  Provider (HCP) nationwide. The choice of service providers in our network has greatly enhanced our administration of the scheme and prompt delivery of services.

Enrolee has the right to select his primary HCP from our   network of  HCPs in  line  with  his subscribed Health Plan.

In a  group policy,  with significant pool, the Client  may  introduce a primary HCP to ProHealth for  the purpose of  including it on our  network of  HCPs, provided not be  less than twenty (20) enrolees indicate interest to use the HCP and the HCP has accepted to abideby the rules and regulations of the scheme and it meets the minimum standards of service delivery of ProHealth and NHIS.

ProHealth HMO has  in  place a  multi-disciplined Quality Assurance department that has  robust system of  quality management for  ensuring that HCPs on  our network meet the standard requirements of NHIS in respect to personnel, facility and maintaining quality assurance in the delivery of health care services under the scheme by regulations and medical guidelines. We continually hold our HCPs to an unquestionable standard of delivery of health care services through quality audits, case management, annual provider accreditation and recertification.

ProHealth  HMO   runs   a   well-equipped  and  functional  24hours  call   centre guaranteeing unhindered interface between HCPs and ProHealth and to ensure calls from Providers are promptly attended to.

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