Healthcare in Nigeria: compulsory insurance, and no CAK
Since the National Health Insurance Authority Act of 2022, everyone living in Nigeria must have health insurance. An employee pays 5 percent of their basic salary, the employer 10. You take nothing with you from the Netherlands: Nigeria is not a treaty country for the CAK, so your Dutch healthcare stops when you leave.
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Anyone living in Nigeria must have health insurance. Section 14 of the National Health Insurance Authority Act of 2022 says it without qualification: "every person resident in Nigeria shall be required to obtain health insurance." If you work in the formal sector, according to the NHIA you pay 5 percent of your basic salary and your employer 10 percent. You take no healthcare with you from the Netherlands. Nigeria is not among the CAK's treaty countries, so even with a Dutch state pension or pension, your Dutch insurance ends when you leave.
What applies?
| Topic | What the source says | Source |
|---|---|---|
| Duty to insure | every resident of Nigeria, including legal residents without Nigerian nationality | NHIA Act 2022, sections 3 and 14 |
| Who the act covers | employers and employees at organisations with five staff or more, the informal sector, and all other residents | NHIA Act, section 14(2) |
| Private insurance | allowed, if you also take part in your state's scheme | NHIA Act, section 14(3) |
| Contribution in the formal sector | employer 10 %, employee 5 % of basic salary | NHIA |
| Who is covered | the contributor, the spouse and four biological children under 18 | NHIA |
| Healthcare from the Netherlands (CAK) | not possible: Nigeria is not a treaty country | CAK |
| Mandatory vaccination according to the GGD | DTP; yellow fever and hepatitis A recommended | GGD Reisvaccinaties |
How does insurance work in Nigeria?
The National Health Insurance Authority (NHIA) replaced the old scheme of 1999 in 2022. Under section 3, the NHIA must ensure that health insurance is "mandatory for every Nigerian and legal resident". States can have their own scheme; the NHIA lists an agency per state. The act lets you take out private insurance, but only if you also take part in your state's mandatory scheme (section 14(3)).
If you are employed, it runs through your employer: they pay 10 percent of your basic salary, you pay 5. According to the NHIA, that contribution replaces the medical allowance you would otherwise receive. Your spouse and four biological children under 18 are covered with you. Treatment is available at providers accredited by the NHIA, not outside them.
If you don't work, for example as the partner of a Nigerian, you fall under "all other residents of Nigeria". What you then pay and under which scheme depends on your state. We did not find the amounts per state at an official source.
Why doesn't the CAK arrangement apply?
The CAK only arranges healthcare for people with a Dutch pension or benefit in a treaty country: the EU, the EEA, Switzerland, the United Kingdom and eight other countries, such as Morocco, Tunisia and Turkey. Nigeria is not one of them. So with a Dutch state pension you get no healthcare in Nigeria at Dutch expense, and you stop your Dutch health insurance when you leave. How to do that without a gap is in cancelling your health insurance without a gap.
NederlandWereldwijd calls healthcare in Nigeria "limited": anyone who ends up in hospital sometimes has to be moved to another country. For every policy, ask whether medical evacuation and return to the Netherlands are included, and whether the cover continues under orange and red. According to NederlandWereldwijd, many insurers adjust their terms under those colours.
Which vaccinations and which preparation?
The GGD lists DTP (diphtheria, tetanus and polio) as mandatory for Nigeria, and recommends yellow fever and hepatitis A. There is a risk of malaria; whether you need pills depends on the region and the month. Whether you have to show proof of yellow fever vaccination on arrival, we could not check at a Nigerian source. Take your yellow booklet anyway.
Before departure, according to NederlandWereldwijd, you fill in a health declaration online with the Nigerian Ministry of Health. The travel advice also mentions Lassa fever, cholera and mpox, and extra checks at airports because of Ebola in Congo and Uganda.
If you use medicines, take enough in the original packaging, and check whether you need a declaration: see medicines across the border.
And if you come back?
If you return to the Netherlands, you are again obliged to be insured as soon as you live here. What that means for your insurance and your registration is in moving back to the Netherlands. How healthcare and insurance fit into the whole plan: the plan for Nigeria.
In Vertrekklaar this is phase 1 of 5 of the journey, step 1.2: the same steps, but for your situation — in your order, tickable, and with the deadlines watched. See the whole journey to Nigeria or go straight to step 1.2 in the open plan.
What this rests on
The facts in this article come from these official pages. Rules change. When in doubt, go by the source, not this article.
- National Health Insurance Authority Act 2022, sections 3 and 14 — compulsory insurance for every resident (gazette) — nhia.gov.ng
- NHIA — frequently asked questions, the contribution in the formal sector and who is covered — nhia.gov.ng
- CAK — the treaty countries for healthcare from the Netherlands (Nigeria is not among them) — hetcak.nl
- NederlandWereldwijd — travel advice for Nigeria, limited healthcare, insurance and health declaration (changed 6 July 2026) — nederlandwereldwijd.nl
- NHIA — the health insurance agencies per state — nhia.gov.ng
- GGD Reisvaccinaties — Nigeria, mandatory and recommended vaccinations and malaria (updated 13 October 2026) — ggdreisvaccinaties.nl
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