Health Insurance Registration

Healthcare Enrolment Form Demo

Make a Selection

Are you a LibertyMatrix Member?

Your LibertyMatrix Username

Parent's Information

Parents' Information

First Name

Last Name

Phone Number

Whatsapp Number

Child's Information

Basic Information for your policy

Child First Name

Child Last Name

Sex

Date of Birth

Phone/Mobile

Whatsapp Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Basic Information

Basic Information for your policy

First Name

Last Name

Sex

Date of Birth

Phone/Mobile

Whatsapp Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Hospital Selection

Select Your Hospital Of Choice

Disclaimer – LibertyHub International Limited

LibertyHub International Limited strives to provide a comprehensive list of hospitals for our users. If your preferred hospital is not currently listed, we can enroll you in your hospital of choice, provided you refer a minimum of ten (10) users to sign up for the same hospital. This offer is subject to the terms and conditions of LibertyHub International Limited and may be modified or discontinued at the company’s discretion. For further details, please contact our support team.

Also note that After registering, there is a 30-day processing period that includes documentation and verification before the HMO issues your ID card, allowing hospital access. You will be notified if the process is completed earlier.

Hospital State

Zamfara State

Yobe State

Taraba State

Sokoto State

Plateau State

Oyo State

Osun State

Ondo State

Ogun State

Niger State

Nasarawa State

Kwara State

Kogi State

Kebbi State

Katsina State

Kano State

Kaduna State

Jigawa State

Imo State

Gombe State

Enugu State

Ekiti State

Edo State

Ebonyi State

Delta State

CrossRiver State

Borno State

Benue State

Bayelsa State

Bauchi State

Anambra State

Akwa Ibom State

Adamawa State

Abia State

Rivers State

Lagos State

FCT - Abuja

Parent's Information

Child's Information

Basic Information

Hospital Selection

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