Lagos health insurance: what the 31 December deadline means for you

What happened

Lagos residents, workers and employers have until 31 December to get health insurance, Governor Babajide Sanwo-Olu announced on 27 October. The state will start enforcing the rule on 1 January 2027.

Sanwo-Olu set the deadline at the launch of the Lagos Private Health Plans, which are for salaried workers and the companies that employ them. The state said 21 health maintenance organisations (HMOs) had endorsed the plans.

The private plans sit alongside Ilera Eko, the scheme run by the Lagos State Health Management Agency (LASHMA) for people in the informal sector and vulnerable residents. The governor said the state now has a plan for every resident, whether they work in the formal or the informal sector.

The requirement itself is not new. Sanwo-Olu signed an executive order in July 2024 that makes health insurance compulsory for every resident, employer and worker in Lagos.

Cover can come through LASHMA or through a private insurer accredited by both the National Health Insurance Authority (NHIA) and the state, according to KPMG’s summary of the order. The order rests on the National Health Insurance Authority Act 2022, which makes health insurance compulsory nationwide.

Why it matters

Officials at the launch said about two million Lagos residents have health insurance, and set a target of at least 10 million. NHIA figures put the state’s total for 2025 at 2.76 million, second only to Delta State.

People without insurance pay for treatment themselves. Health Commissioner Akin Abayomi said at the launch that these out-of-pocket payments put financial pressure on families and on hospitals.

The yearly Ilera Eko premium is N15,000 for one person, N55,000 for a family of four and N80,000 for a family of six, Adesegun Ogundeji, a coordinating director at the Lagos State Ministry of Information and Strategy, said in August. Officials listed consultations, specialist, dental and eye care, some surgeries, emergencies, children’s care, tests and prescribed drugs among what it covers.

Lagos public servants are already enrolled. The state pays 75 per cent of their premium and workers pay the rest, LASHMA Permanent Secretary Emmanuella Zamba said at the same event.

The state has not published prices for the private plans. It says licensed actuaries reviewed nearly two million claims and enrolment records to work out what cover for salaried workers should cost, and that HMOs must spend at least 70 kobo of every naira they collect on care.

Sanwo-Olu said employers should treat their workers’ healthcare as a necessary cost of doing business, like pensions. The state has not said whether employers must pay the whole premium or can share it with staff.

What happens next

Two industry associations, the Health and Managed Care Association of Nigeria (HMCAN) and the Association of Health Insurance Practitioners of Nigeria (AHIPN), said in a joint statement on 29 October that they had not endorsed the private plans. Individual HMOs taking part in the launch did not amount to an industry endorsement, they said.

The associations want the plans approved by the National Health Insurance Authority first. They also asked Lagos to recognise existing NHIA-approved cover, explain a reported 13 per cent levy and review the 31 December deadline.

An implementation steering committee will oversee the rollout, and an enforcement task force will check compliance from 1 January. The state has not said what enforcement will involve, or what penalty, if any, people without insurance will face.

LASHMA says it will step up enrolment drives with traditional rulers, market associations and transport unions. The Health Equity Fund, raised from N1 billion to N3 billion, will cover more than 500,000 residents who cannot afford a premium, LASHMA Chairman Adebayo Adedewe said.

The state says it will publish the results of its monitoring of HMOs every quarter. We will update this explainer when Lagos publishes the private plans’ prices, explains how enforcement will work or changes the deadline.

Sources: Nairametrics; KPMG summary of Executive Order EO/BOS/01 of 2024; Leadership; ThisDay; Punch; The Sun