As more Nigerians gain access to health insurance, attention must also turn to the quality of care they receive, the respect they are shown and whether their coverage genuinely protects them from unexpected medical expenses.

The National Health Insurance Authority (NHIA) has continued to expand its programmes, with its official website reporting more than 23 million people covered. This represents progress towards broader financial access to healthcare, although coverage figures alone cannot establish whether patients consistently receive timely, respectful and appropriate treatment.

One concern that deserves attention is the way some insured patients may be treated differently because their medical bills are paid through a Health Maintenance Organisation (HMO) or another insurance arrangement. Reports of delayed attention, poor communication and dismissive attitudes raise questions about whether insurance status can influence a patient's experience at a hospital.

A social media controversy involving a derogatory remark about a family receiving care through insurance brought the issue into public discussion. Beyond that particular incident, the wider concern is whether other patients have experienced similar treatment without their complaints ever becoming public.

Health insurance is intended to reduce inequalities in access to medical care, not create another basis for discrimination. A patient's entitlement to respectful treatment should not depend on whether they pay directly, use private insurance or receive care through a public scheme.

Quality healthcare goes beyond the eventual delivery of treatment. It also includes how patients are received, how long they wait, how clearly their options are explained and whether their dignity is respected throughout the process.

At the same time, the challenges facing healthcare providers cannot be ignored. Hospitals and clinics must pay staff, purchase medicines, maintain equipment and cover other operating expenses. Providers may also face disagreements with insurers over treatment tariffs, the actual cost of services and delays or uncertainty surrounding reimbursements.

These concerns are particularly significant for private facilities, which must remain financially viable to continue operating. But when disputes arise between providers and insurers, patients should not become the ones forced to bear the consequences.

There have been concerns about insured patients being asked to make additional payments for services they believe are covered by their plans. Questions have also been raised about billing practices, including whether charges accurately reflect the services delivered. Such concerns require proper investigation rather than blanket accusations against healthcare providers.

Where a service is covered by an insurance plan, patients should receive clear information about any legitimate exclusions, co-payments or additional charges. Providers should not use patients to settle disagreements over reimbursement, while insurers must ensure that their benefit packages and payment arrangements are transparent.

The solution is not simply to increase tariffs or expect hospitals to absorb unsustainable costs. Higher tariffs without careful consideration of the wider financing system could increase pressure on insurers and ultimately patients. On the other hand, persistently inadequate reimbursement could undermine providers' ability to maintain standards and deliver quality services.

Nigeria therefore needs a more balanced approach to healthcare financing. Government should examine the costs of delivering care and consider targeted support or fiscal measures where appropriate, particularly where these can ease pressure on providers without shifting the burden to patients.

Insurers must reimburse providers fairly and within agreed timelines, while healthcare facilities should remain accountable for the quality of treatment they deliver and the claims they submit.

Effective monitoring is equally important. Billing records should be checked, unusual claims should be investigated, and charges should correspond with services actually provided. Patient complaints must be taken seriously, followed up and resolved. Where investigations establish repeated violations, appropriate consequences should follow.

The NHIA's responsibilities include promoting access to healthcare and overseeing the insurance system under its mandate. Stronger coordination among regulators, insurers, state health insurance agencies and healthcare providers will be necessary to ensure that expanding coverage translates into meaningful protection for patients.

Patients also need to understand their rights and the terms of their insurance plans. They should be able to seek clarification about covered services, question unexplained charges and report poor treatment through the appropriate complaint channels.

The objective should not be to eliminate profit from healthcare. Rather, the system must strike a balance between financial sustainability and the fundamental responsibility to provide patients with appropriate care and dignity.

As Nigeria continues to expand health insurance, success should be measured not only by the number of people enrolled but also by whether they can access the services promised under their plans without unnecessary delays, unfair treatment or unexpected financial pressure.

The country still has an opportunity to address these challenges as its health insurance system develops. Government, insurers and providers must work together to close gaps in financing, improve accountability and protect patients from being caught between competing institutional interests.

Ultimately, health insurance exists to protect people when illness strikes. Its growth will mean far more when every enrollee can enter a healthcare facility with confidence that their coverage will be respected and their dignity upheld.