Benefits of NHIF to the Public
The National Health Insurance Fund, abbreviated as NHIF is a Kenyan government state owned corporation that is charged with a mandate of providing health cover or insurance to Kenyans. Notably, the agency covers individuals aged 18 years and over. The main reason why this corporation was set up was to ensure the availability of accessible, sustainable, affordable and quality health care. This agency however has an exception in that its members must have a minimum of 1000 Kenya shillings per month.
History
The NHIF saw its establishment in the year 1966. It came up as a department under the ministry of Health by a parliamentary act.
Benefits of NHIF to Kenyans
It helps in providing admission to members in hospitals by catering for the services rendered as the hospital only makes claims to the Fund for the reimbursement of the services rendered.
The Fund also provides patient cover for the member, the declared spouse at the time of registration and the children therein.
NHIF also provides comprehensive medical cover in majority of over 400 accredited Government facilities, Mission health providers and some private health providers across the country.
Besides the aforementioned, NHIF also strives to provide in-patient services in private and high cost hospitals on a co-payment arrangement.
The corporation also provides comprehensive maternity and CS (Caesarian) package in government hospitals, majority of mission and some private hospitals countrywide.
The body has also made it possible for the Kenyan citizens to enjoy such services as dialysis at Ksh 2,500 per session at the following medical facilities:-
- Kenyatta National Hospital, Nairobi
- Moi Teaching & Referral Hospital, Eldoret
- Provincial General Hospital Kisumu
- Rift Valley Provincial General Hospital, Nakuru
- Coast General Hospital, Mombasa
- Siloam Hospital, Kericho
- Mediheal Hospital & Fertility Centre
- Muranga District Hospital, Muranga
- Thika Level 5 Hospital, Thika
- P.C.E.A Hospital, Kikuyu
- Consolata Hospital, Nyeri
- Tawfiq Hospital, Malindi
- Africare Limited
- Kakamega Country General Hospital
Family planning' Vasectomy and Tubal Ligation
NHIF does not exclude any disease.
Benefits Package Inpatient/Outpatient Scheme
Contributions and deductions
The contributions from employees from the formal sector are subjected to deduction and remissions to the Fund by the respective employers. This is often achieved through cheques and or E-banking.
Those who belong to the voluntary category are supposed to pay 500 shillings on a monthly basis, an equivalent of 6000 annually. In the formal sector, the NHIF membership contributions are made based on one’s income.
Payment of claims
The NHIF payment claims are submitted by the hospitals that render the health services directly to the NHIF body after discharging the contributor from the facility. The claims are then cross-checked by the Fund just to be sure and verify the payments.
This body attempts to pay funds within the 14 day-claim upon receiving the claim from the hospitals. The members who might resort to paying the bills with the hospital may also launch their general claim that is fronted directly to the NHIF for reimbursement.