Frequently asked NHIF questions and answers


Q1. What happens in case of Emergency and away from facility chosen? You will be treated in the NHIF accredited health facility nearest to you.

Q2. Are my parents covered?

  1. The cover is only for principal member, declared spouse and


Q3. What happens to my medical limit if I don’t use it?

It lapses at the end of the financial year.

Q4. What happens once the limits are exhausted?

There are no extensions once the limit is exhausted, however the Principal Member may apply to the Principal Secretary for medical ex-gratia assistance.

Q5. Why choose a facility?

The scheme allows members to choose a healthcare facility for ease of accessing quality services.

Q6. Can I choose a different facility for each dependant?

Yes. You can choose a different facility convenient to each dependant.

Q7. Is one required to choose an inpatient facility?

  1. For inpatient one can be admitted in any health facility subject to the NHIF contract with the facility.

Q8. What happens when one is transferred?

One is allowed to change healthcare facility.

Q9. Is a member still covered once interdicted?

YES. A member remains covered.

Q10. Why limit the number of beneficiaries?

To maintain sustainability of the scheme based on government funding.

Q11. Do I have to do a medical test/examination before joining the


  1. But under the scheme the principal member is entitled to a voluntary annual medical check-up.

Q12. Once referred who should settle the bill?

Bills will be settled by the selected healthcare facility for outpatient services and NHIF for inpatient services.

Q13. If I’m unhappy with the services, how can I be assisted?

You can raise it as a complaint through the existing channels.

Q14. What of disabled dependants who are over 25 years of age?

They remain beneficiaries under the scheme.


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