Expat insurance and health insurance in Nigeria

Nigeria’s healthcare system rests on three levels (federal, state, local) with very uneven provision depending on the region. The national health insurance scheme, the National Health Insurance Scheme (NHIS), was reformed by the National Health Insurance Authority Act of 2022, which turned it into the National Health Insurance Authority (NHIA) with a universal health coverage objective and mandatory enrolment for federal civil servants. In practice, coverage remains very low: around 21.7 million Nigerians were covered in 2025 (up from 19.2 million in 2024) according to the federal Ministry of Health’s State of Health of the Nation 2025 report, close to 13% of a population estimated at over 220 million. The Basic Health Care Provision Fund 2.0, launched in October 2025, enrolled around 2.7 million additional people in the fourth quarter of 2025, primarily among vulnerable populations. France Diplomatie describes Nigeria’s care system as «precarious» and notes that outside Abuja and Lagos, emergency care and hospitalisation options under decent conditions are uncertain. In Lagos and Abuja, however, an expanding private sector — driven in particular by the business and expat community — offers better-quality facilities (Reddington Hospital, Lagoon Hospitals, Eko Hospital in Lagos; Nizamiye Hospital, Cedarcrest Hospitals in Abuja), without all of them systematically reaching Western standards or local medical evacuation capacity.

• Mandatory visa for any stay, regardless of purpose: application to be built on the Nigerian immigration portal, filed and paid for at the Online Integrated Solution (OIS) centre, 7 rue Daru, 75008 Paris. Since 1 May 2025, an e-visa system allows electronic application and issuance for certain categories (tourism, business, short stay), with an announced processing time of 48 hours; to be checked case by case depending on the purpose of the stay, as both routes (OIS and e-visa) appear to coexist in the sources reviewed.
• Electronic arrival/departure card mandatory since May 2025, to be completed online before check-in at lecard.immigration.gov.ng.
• Passport valid for at least 6 months after the planned return date.
• Yellow fever: vaccination not mandatory according to France Diplomatie, but «very strongly recommended», as the international vaccination record may be required by the Nigerian authorities at the border.
• Malaria: described as the «main health risk in Nigeria» by France Diplomatie, across the entire territory — vector protection and chemoprophylaxis to be assessed with a doctor before departure.
• France Diplomatie describes taking out an assistance contract covering medical expenses, surgery, hospitalisation and medical repatriation as essential, since costs are covered neither by the embassy nor by any automatic Nigerian scheme. No proof of health insurance has been identified among the documents required for the visa in the sources reviewed.
• Zones formally advised against by France Diplomatie: the states of Borno, Yobe, Gombe, Bauchi, Adamawa (north of the Benue), Jigawa and Kano in the north-east (terrorist group activity), as well as the states of Bayelsa, Rivers, Delta and Akwa Ibom in the Niger Delta (serious crime, including kidnappings). France Diplomatie does not explicitly detail the impact of these zones on care capacity; by inference from the general finding on emergency and hospitalisation options outside Abuja and Lagos, access to reliable emergency care is, in practice, even more uncertain there than elsewhere in the country.

Other health risks reported by France Diplomatie: cholera endemic in the north (May to September), recurrent bacterial meningitis in the north (October to May), Lassa fever, diphtheria and mpox.

No bilateral social security agreement between France and Nigeria has been identified. CLEISS does not list Nigeria among the countries that have signed this type of agreement with France — unlike neighbouring or nearby countries such as Niger, Benin, Togo or Mali. In the absence of any agreement, there is no coordination for healthcare, maternity, old age or family benefits between the two systems.

• No French rights-maintenance form applies in Nigeria.
• Registering with CFE or taking out international private insurance are the only routes to cover recognised by a French system, regardless of profile.
• Enrolling in the Nigerian NHIA (via a local employer for the formal sector) gives partial access to the local system but does not constitute cover recognised in France, nor a substitute for medical repatriation.

• Before departure, regardless of purpose: build the visa application on the Nigerian immigration portal (filed and paid at the OIS centre in Paris, or e-visa online depending on the stay category since May 2025), complete the electronic arrival/departure card, and take out an assistance contract covering hospitalisation and repatriation, given the absence of any France-Nigeria coordination.
• Before departure: medical consultation/vaccination centre visit to assess the need for yellow fever vaccination (strongly recommended), and antimalarial prophylaxis, as malaria is present across the entire territory.
• Check the precise destination zone on France Diplomatie's travel advice map before any travel outside Lagos or Abuja, particularly toward the north-east or the Niger Delta.
• Voluntary enrolment with CFE recommended given the absence of any healthcare coordination.
• Within 6 months of arrival: register with the roll of French nationals living abroad, at the French embassy in Abuja or the consulate general in Lagos.