Services offered by the National Hospital insurance Fund, NHIF- Kenya
SERVICES OFFERED BY THE NHIF
NHIF is geared towards provision of accessible, affordable, sustainable, equitable and quality social health insurance through optimal utilization of resources, to the satisfaction of stakeholders.
INPATIENT SERVICES
This comprehensive in-patient health cover has been introduced for NHIF contributors and their dependants. The actualization of this package is a culmination of continued reforms at NHIF. Such reforms include efficiency, arising from decentralization of NHIF services and continued partnership with health providers on enhanced quality services to all members. To enhance these benefits, NHIF has contracted hospitals under three Categories; A, B & C, to provide this in-patient medical cover and partial cover for surgical cases in some of these hospitals. Our members are at liberty to attend hospitals under any category.
Under Category A (government hospitals), members would be able to enjoy full and comprehensive cover for maternity and medical diseases including surgery. In short, they will not need to pay for anything on admission provided they are fully paid up members of NHIF. Members admitted under contract Category B (private and mission) hospitals will enjoy full and comprehensive cover but where surgery is required, the contributor may be required to co-pay.
Those visiting facilities contracted under Category C (private) will continue with the current system where NHIF pays specified daily benefits under the current arrangements. NHIF will continue to negotiate with other health providers not appearing in the list below to determine which category of contract they will sign. Members will be informed of additional hospitals as and when they sign the contracts.
Below is a list of Hospitals, Number of Beds and Contracts covered by NHIF.
OUTPATIENT SERVICES
The National Hospital Insurance medical scheme is a social health insurance operated by NHIF. The scheme commenced out-patient services in July 2015. The scheme is yet another of the various health insurance products offered by the NHIF such as Civil Servants & Disciplined Services Medical Cover, Health Insurance Subsidy Programme for the poor, and elderly and people with severe disabilities. The National Health Insurance Scheme is affordable and all inclusive with the following features:
i. No exclusions for all medical conditions except cosmetic procedures
ii. No upper age limit for members to join
iii. No limitation on the number of declared dependants
The national scheme seeks to ensure that every individual and/or family enjoy comprehensive In-patient and Out-patient covers to save them from the effects of unpredictable and catastrophic spending on medical bills. The national scheme is a social comprehensive cover and health facilities have been contracted by NHIF country wide to provide the services under the scheme. NHIF acknowledges that many families without health insurance cover have been pushed into abject poverty and inhumane treatments such as detention in hospitals for their inability to pay medical bills or worse still, by disposing off valuable family assets.
