NHIF EDUAFYA SERVICES, KENYA

The Ministry of Education and NHIF signed a contract on 13th April 2018 to offer a unique Comprehensive Medical Insurance Cover for Public Secondary School Students during the duration of Study. Download EduAfya Bochure

1. General Out-patient Services: Outpatient services provided by or on the order of a clinician/ physician who is licensed as a general practitioner.
2. Specialized Out-patient Services: Outpatient services provided by or on the order of a physician who is licensed as a specialist or consultant and to whom a Member has been referred to by a general practitioner/Primary Care clinician where a member was registered.
3. This caters for all routine outpatient services as per Kenya essential package for health subject to policy terms and conditions.
4. Referral for specialized services which includes the following:
   1. Drug and Substance Abuse Rehabilitation Services
   2. Renal services and dialysis
   3. Specialized radiological diagnostic services
   4. Chronic ailment services such Diabetes and Hypertension, Ultrasound, ECG,
   5. Cancer medical care and treatment services which includes radiotherapy services, chemotherapy services or surgical intervention subject to preauthorization by the fund

1. Extraction
2. Root canal
3. Dental X-ray Services
4. Accident related inpatient Dental cases will be covered under the standard inpatient surgical benefits to the full inpatient limit.

1. Consultation
2. Eye testing
3. Prescription for ophthalmic treatment and prescription of eye glasses
4. Accident related inpatient optical cases will be covered under the standard inpatient benefits to the full inpatient limit.

1. Hospital accommodation charges
2. Pre-hospitalization diagnostic services
3. Doctor’s (physician, surgeon & anesthetist) fees.
4. Nursing charges
5. Drugs/medicines, dressings and internal surgical appliances.
6. Diagnostic, laboratory or other medically necessary services
7. Rehabilitation services
8. Operating theater services
9. Radiological diagnostic e.g. x-ray services, CT scan, MRI,ECG
10. In-patient physiotherapy.
11. Day care surgery surgical procedures that do not require overnight stay.