Register for health insurance for Nigerian's (NHIS/ANAC)

OPTION #1: APPLY ONLINE

Fill out the following form to apply online for benefits of NHIS Nigeria Insurance. Include all doctor office visits, lab cost, pharmcy cost, hospital care cost, surgery cost and OB-Delivery cost while in Nigeria. You will then be contacted via phone or e-mail so that your payment information can be processed.

Name:

Address:

City:

State/Provence:

Country:

Zip/Postal:

E-Mail:

Phone Number:

Agent Number (if known):


Type of Membership (select one):

Individual -- $250 per year

Husband & Wife -- $350 per year

Individual Sponsorship-- $250 per year    Note:Please write nane and address and email of person to be sponsor
                                                                      in comment box below.

Large Family -- $450 per year


Additional Comments/Suggestions:



OPTION #2: APPLY BY PHONE

Your application can be processed quickly over the phone. Have your credit card and information ready and call one of our representatives at:

301-423-4834 or
202-496-5307


OPTION #3: APPLY BY MAIL:

If you prefer you may instead simply download our form and print it out on your printer. Insert the form in an envelope and mail it to:

All Nigeria American Congress
P.O. Box 6500
Largo, MD 20792

Click here to download the form if you are an Individual or Family

Click here to download the form if you are an Organization

 
Donald Payne

U.S. Congressman
(Committee Africa
& International
Relations)
Keynote:
Economic and
Anti-Corruption
Town Hall Meetings




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