As public resources to finance health care in Nigeria continue to decline, the country has embraced the concept of health insurance as a source of significant alternative funding. And based on experience gathered from the implementation of the National Health Insurance Scheme, there is strong evidence to suggest that this idea is feasible in Nigeria. However, with a very low coverage rate, the health insurance programme in Nigeria is facing many challenges that have slowed down progress. This presentation reflects on these issues and notes that the current system of health insurance in the country is still useful in securing universal financial access to healthcare for all Nigerians. What is required is to: strengthen already existing structures, modify areas that need adjustments, and facilitate rapid programme uptake especially at the State level through creative engagement with stakeholders.