Patients Must Be Attended to Within One Hour, NHIA Warns HMOs

Health Maintenance Organisations (HMOs) in Nigeria have been issued a stern directive not to keep enrollees on health insurance plans waiting beyond one hour before receiving medical attention at their chosen healthcare facilities.

This warning was disclosed by Otunba Lekan Ewenla, Managing Director and CEO of Ultimate Health Management Services, during the company’s 14th Annual General Meeting held in Abuja on Thursday.

Ewenla, a former member of the governing council of the National Health Insurance Scheme (NHIS), explained that the National Health Insurance Authority (NHIA) issued the instruction in response to a growing number of complaints from enrollees about excessive delays and neglect at hospitals.

“Too many patients spend an entire day at hospitals just waiting to be seen. The NHIA has made it clear—this is no longer acceptable. Patients under the health insurance scheme must not wait more than one hour to receive care,” he said.

He likened the NHIA’s role in healthcare to that of the Central Bank of Nigeria in the financial sector and PENCOM in pension administration—regulating, monitoring, and enforcing standards to protect consumer rights.

Responding to the NHIA’s directive, Ewenla stated that Ultimate Health Management Services had not only met the one-hour benchmark but significantly exceeded it.

“Our average waiting time is currently 10 minutes, and we are working towards reducing it to five,” he noted.

To support this, the HMO has implemented advanced health management software and introduced a pre-notification system. This allows patients to inform the HMO of their planned hospital visits in advance, enabling the HMO to coordinate directly with healthcare providers.

“We even follow up with reminder calls to hospitals on the day of the visit. This aligns with global standards. Healthcare must be taken seriously,” he added.

Ewenla emphasized that access to quality healthcare is a basic human right, and health insurance is the most reliable way to achieve that access.

He also unveiled a new initiative targeting Nigerians in the diaspora who wish to support their ageing parents and dependents in Nigeria through structured health insurance plans.

“Sending money home for medical care isn’t always sustainable,” he said. “We’ve developed a system where diaspora Nigerians can pay a fixed premium and enroll their loved ones in our health plans.”

This diaspora outreach has already launched in the United States, with Ewenla engaging the Nigerian Consulate in Atlanta, Georgia. Efforts have also extended to community centers such as churches, mosques, and grocery stores run by Nigerians.

According to him, regulatory support is being sought to scale the program and ensure widespread adoption.

However, he warned that success also hinges on cultural change among Nigerians, particularly in respecting systems and regulations.

“The same disregard we show for traffic rules is often reflected in our approach to healthcare. That mindset must change. That’s why we’re working closely with regulators to reset public expectations,” he said.

Also speaking at the event, the Board Chairman of Ultimate Health Management Services, Mrs. Angela Ajala, stressed the importance of patient-centered care and transparency.

She decried the growing trend of delayed claims settlements by some HMOs and reiterated her firm’s commitment to prompt and efficient service.

“At Ultimate HMO, we prioritise the wellbeing of our enrollees. Settling claims on time is central to our promise,” she said.

Ajala called on industry players to embrace innovation, respond to emerging healthcare needs—including mental health, telemedicine, and support for children with special needs—and remain adaptable in a fast-evolving sector.

“To remain relevant, we must think ahead. The needs and expectations of patients are changing,” she concluded.