AVON HMO VS RELIANCE HMO
This is not a sponsored post
Have you ever wondered about getting a health insurance plan? Doing endless research to find out which one gives you the best services at the most affordable prices. When it comes to HMOs (Health Maintenance Organization) in Nigeria, there is quite a number, but a substantial few stand out. These two HMOs in this article have continuously provided top-notch quality service to Nigerians. Before we go into the main article, we must first ask what is an HMO? A health maintenance organization (HMO) is a network or organization that provides health insurance coverage for a monthly or annual fee through a network of healthcare providers.
Types of HMOs in Nigeria
- National: this allows the organization to operate in all parts of the country including the Federal Capital Territory.
- State: This allows the organization to operate within a given state
- The third allows the organization to operate in all six geopolitical zones
Questions To Ask Before Choosing A HMO
- What type of plans are available?
- The indemnity health plan is known as a fee for service. This is where you pay a percentage of the medical costs and the insurance company pays the rest.
- Managed Care Plan: This involves an agreement with an HMO. You, your company, or employer pay a fixed monthly, quarterly or annual fee for health care services
- What benefits are included: Dental, Visual care, prescription services, and others
- If it operates on a national, state, or other structure
- Does it cover pre-existing conditions?
- Do I have to call my doctor before I go to the hospital?
The two HMOs that I am writing about in this article have stood out when it comes to delivering optimal service both to the satisfaction of customers and healthcare providers.
This organization was founded in 2012 and commenced operations in 2013. Avon HMO is a subsidiary of HEIRS holding. If the name Heirs holdings sound familiar, well it’s because it is owned by Chief Tony Elumelu of UBA group, Transcorp, heirs’ oil and gas, Tony Elumelu Foundation, and more. So we should expect nothing but top-class service and affordability.
The Chairperson and founder of Avon is Dr. Vivian Elumelu, she is a well accomplished medical doctor who obtained her medical degree from the University Of Benin. She has worked at the Lagos University Teaching Hospital (LUTH) in the UK, with Grantham and District Hospital, Grantham. She is dedicated to providing quality, affordable healthcare services.
The CEO of Avon HMO, Adesumbo Ukiri, who obtained her law degree for Obafemi Awolowo University, then proceeded to further her studies at the London Business school, and has an exceptional track record in Marketing, Sales and Distribution and Business Development functions in challenging entrepreneurial environments has said that Avon will ensure that Nigerians from all works of life have access to adequate and effective healthcare services
A quick glance at who occupies the board of directors’ seat at Avon will give you a clearer picture of the standard they have set and the exceptional talents on the board. Each individual with their own wealth of knowledge and experience to add to the Avon organization.
Avon has plans for individuals, couples, families, SMEs, and large companies
Individual plans Yearly
In terms of the individual plan, this plan is very affordable considering the number of services you qualify for. They definitely have one of the most affordable plans in the market
This plan is 73,360 per year and grants you access to a plethora of services from specialist consultations to all-year-round admissions to a 250.000 limit on surgeries. Their plans encompass a lot and are just too good to be true.
Family Plan: These include
- Life Plus 202,500
- Premium Life 314,995
- Boss Life 694,495
These plans are for a family unit of six. Two parents and four kids. Kids must all be under the age of 18. Every family should have a health insurance plan in my opinion.
Small Business Plans
Small business plans are a combination of individual and couple plans.
For Large Companies
You will have to call for a quotation
Avon HMO was named among the Top 10 best companies to work for in Africa. This is welcome news as toxic workplace culture has held sway in Nigerian companies for a very long time. Avon also has a telemedicine arm that enables you to chat with a doctor at any time of the day or night and was one of the first HMOs to enable payment of plans via your atm card.
Word Of Mouth
I must be honest, some of the doctors I called had a lot of good things to say about Avon especially hospitals that are based in developing areas, e.g. Ajegunle, Oshodi. They are especially in love with Avon’s fee tariff for treatment rendered to customers. This was their main compliment for Avon HMO. During the END SARS movement, Avon was one of the few, if not the only HMO that offered free health and ambulatory services to those that needed them.
Reliance Health leverages technology as a tool to make healthcare delivery more accessible, more optimal, and affordable.
Femi Kuti is a co-founder and until recently the CEO of Reliance Health. He obtained his medical degree from Obafemi Awolowo University. After that, he proceeded to Goldman Sachs where he worked as an investment banker with specialties in advising biotech, healthcare, and pharmaceutical corporations.
Opeyemi Olumekun is the COO of Reliance Health. He obtained a degree in geology from Obafemi Awolowo University. He began his career in the trading division of Goldman Sachs London office. Mr. Opeyemi cofounded Kangkpe with Femi Kuti and Mathew Mayaki. Kangkpe is now the telemedicine arm of Reliance Health.
The Board Of Directors of Reliance Health can only be described as “A COVEN OF ENRICHED MINDS ALL CHANNELED TOWARD A SINGLE GOAL. Forget my words, Check out their board members.
Reliance Health Plans
They are just cheap, with plenty of benefits…In short, the plans make me happy. These are some of the individual plans.
The above plans are beyond affordable and come with a load of benefits from eye surgery coverage down to gym memberships. Their plans ensure that you do not have to go broke every time you visit the hospital. Reliance health also has an added benefit of onsite clinics. They also have a telemedicine arm where you can chat with doctors, get a medical prescription, and have those drugs delivered to your doorstep.
Reliance even gives 20% of your annual premium if you stay healthy for a whole year. Their app also enables patients to find a doctor near them.
Reliance uses analytics to provide lifestyle advice to some of its customers. e.g those that have chronic conditions. Reliance also uses tracking, monitoring, and analytics to determine if a patient had a long wait at the hospital and provide other options closer or less populated for users. They recently got $40,000,000 in investment funds from private equity firm General Atlantic. They are already planning strategic launches in Egypt and other African Countries.
Reliance seems to be the darling of hospitals. Why? You ask, well Reliance pays almost immediately. Yes, I mean if a patient walks in and is attended to by the doctor. Once the claims are filed, Reliance Health pays before the close of business on that day. It doesn’t matter if it’s one client or 10 that you file in a day. Reliance will pay the latest 24hrs after claims are filed. Reliance also has a Pre-Existing conditions plan for chronic ailments
Word Of Mouth
One general complaint though from all but one doctor that I called is that Reliance tariffs are really really small. The fees remitted to healthcare providers for the rendering of services are small. As a colleague put it “imagine you charge #250,000 for a myomectomy normally in your clinic and Reliance Health will be offering way lesser than what your normal fee would be. I think this pricing would depend on the tier classification of the hospital though. While this may be all jumping for joy for the customers, the healthcare providers feel that Reliance should increase their fee remittance.
The current CEO and country Manager, Novo Abere, who was previously the Senior Vice President of corporate sales has stated that Reliance Health will forever remain committed to providing the best, most affordable, and flexible plans for all Nigerians.
Both HMOs featured in this article offer outstanding plans with even more outstanding benefits. It’s up to you and your family to choose the one that best fits your budget.
WHAT I WOULD LIKE TO SEE
A Standard Plan For SMEs
Both HMOs lack a plan suited for small businesses on the onset, Avon combines individual, couple, and family plans while Reliance requires a call-in for quotations. Policy in Nigeria does not give room for growth for MSMEs. A comprehensive plan for anything from 5 to 25 workers should be available and it should be the cheapest plan. Some benefits can be removed or curtailed.
A Points Awarding System
A point awarding system that is transferrable. E.g if customer A has not visited the hospital all year and gets his 20% refund, he should be able to transfer or gift it to a friend, employee, or colleague.
A Payment System Solely For HealthCare Purposes
Before you bite my head off, I know Flutterwave and Paystack are doing wonders in the fintech space but just hear me out. A payment app to link payments, like a mobile ‘health wallet’ that allows people to save, borrow, and share money for healthcare at very low costs. Donors and insurers can use it to offer healthcare financing products, such as vouchers, managed funds, and low-cost health insurance, to specific segments (poor people) of the Nigerian population. This will bring transparency and accountability to all stakeholders involved, from the patient to the government.
A Medical Savings Account Feature
This would enable the customers to convert their points or 20% reward to a medical savings account which they can take from if they exceed their cover threshold. It will allow people to control where their rewards or where points go to.
An Award System
For instance, if a baby is born on the date Reliance or Avon was founded, the baby gets certain benefits, it could be free care, scholarships, etc.
Mobile Money Integration
This may involve partnering with a mobile telecom operator e.g., MTN. MTN recently got approval to operate a mobile money bank. HMOs could partner with them to convert people’s credit on their phones to cash or hospital plan points. They would be able to go into a hospital and show their momo money balance or reliance credits. Once they type a code or request a code, it is sent directly to them, the patient shows momo id or reliance token, and points or credit is deducted and converted to cash for healthcare providers.
Reliance or Avon Telemedicine Serving As A White List For Healthcare Providers
This simply means that Reliance or Avon will provide the platform to integrate doctors who are not under their (Reliance Health) direct employ. Doctors would have to be employees of partner hospitals and would be integrated into Reliance Telehealth. This would be a source of extra income for doctors. Like an Uber for Doctors. It would guarantee more freedom than your conventional telemedicine operations. This would boost revenue and also increase patient trust.
They Could Take It A Step Further And Initiate a Nurse Homecare Booking Feature
This would allow customers to book home care treatments, wound care, wound dressing, etc. The HMO would have already established itself as a trustworthy authority which would in turn drive customers to use and book this feature. They could also integrate nurses who are in the employ of their partner hospitals. Everybody needs extra income. Imagine how many nurses would sign up and how they would also let their patients know about The HMO in question. Word of mouth is a powerful tool.
Accepting Crypto Payments
An HMO could develop a health token tied to the US dollar or Naira (preferably dollar). Customers can pay, renew and upgrade their premiums with crypto tokens. They would also be able to exchange their points with the token or vice versa.
Value-based programs, medical billing, medical savings account. All of this would increase revenue collection for both the HMO and healthcare providers. Healthcare blockchain/ token-based payments are the future of financial transactions. Blockchain adoption would also lead to securing EMRs (emergency medical records) on a decentralized network that could be shared across a network of medical and financial personnel.
Medical Billing can definitely benefit from cryptocurrency. Imagine as a patient, you have an emergency or undergoing chemotherapy and your plan does not cover it, you can pay with an Avon or Reliance Token. You can also do the same for a relative. The HMO would encourage crypto adoption by rewarding its most active crypto adopters or something in that line. Doctors and service providers should be rewarded and encouraged to sign up.
Blockchain will speed up and upgrade care delivery simply because of the elimination of middlemen, banks, brokers, traders, etc. The patient receives service, files a claim, and receives payment. Healthcare tokens have a $403 million dollar market cap on decentralized exchanges, I don’t see why Nigerian health tech can’t have their share. Even the ledger technology on the blockchain is already being used to manage EMR records and manage disease outbreaks. This blockchain model would be a live-to-earn model. It would be the healthier you are, the more token rewards or points you earn (for patients)
Activity Pools For Token Rewards/Points
This would incentivize people to stay healthy or stay active. Run 10 miles, receive a token, reduce abdominal fat, get a reward, drop a significant amount of weight, and get a reward. Clean up the streets, save a cat, and get a reward/token. The list is endless.
We all know how valuable health data is, IBM bought Truven Health Analytics for $2.6 billion dollars. Each patient data that was acquired was worth 13 dollars. On the black market, patient medical data is worth $250. This gives you an idea of how much big tech is pouring into health analytics. Let’s not even talk about big pharma that pays billions annually for patient health records and real-time patient data. According to Statista, 54% of internet users are willing to share their data for a reduction in premium prices or discount vouchers. Research shows that people are willing to give up control of their data if they are incentivized. Data collected from care points can be used to
- Predict and manage cluster outbreaks
- Provide hospitals with data on which drugs were most consumed, and at which period or season.
- If there is an emergence of a resistant strain of a certain disease.
These use cases and many more are probably just the tip of the iceberg.
Considering how early the HMO adoption plan is in Nigeria, there is room for massive improvement and outreach. The health information and data industry is a billion-dollar gold mine that is still currently untapped. I highly doubt a lot of young Nigerians would just go up and sign up for a plan unless it’s offered by their company. Awareness, education, and literally spreading the gospel of health insurance via every media possible should be the goal of organizations and the government. Which HMO do you prefer? Do you have personal experiences? Please share
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