Strategic Transformation Towards Universal Health Coverage In Kenya
The National Hospital Insurance Fund is a government sponsored parastatal body. NHIF was established in 1966 with the aim of helping workers attain affordable medical cover without engaging other insurance firms. The NHIF currently provides health services to some 7+ million Kenyans per year.
The scheme being a statutory contribution, deductions or premiums are made according to one's earnings. This medical scheme also caters to self-employed persons or voluntary contributors
For employers, it’s mandatory to make deductions from their employees and submit to the parastatal scheme without fail for every subsequent month. The employer is always the first to register and acquire a certain number that will be quoted on the payroll as the contributory number.
The employees also register and get their personal numbers. Their contributions are then directed to that pool which is also their account. The government has made it easy by creating an online registration application for both employers and employees.
How NHIF Works
The scheme caters to both inpatient and outpatient covers. One is required to associate or register with one hospital where you will attend all your clinics for the outpatient cover. The inpatient cover is more flexible.
You can be admitted to any hospital that is accredited within the country. The contributions you have made will have to be up-to-date to enjoy the cover.
Benefits of NHIF
1. Comprehensive medical cover in all government and other accredited hospitals for general illness.
2. Complete cover for maternity and caesarian section in all government and some mission hospitals.
3. Inpatient covers as a co-payment in high-cost hospitals.
4. Dialysis treatment in selected referral hospitals.
5. Prescription and issuing of drugs and medicines.
6. Investigations and Laboratory tests.
7. Prescribed ultrasound and x-ray diagnosis.
8. Consultation with general practitioners
9. Terminal illness covers like cancer to a certain percentage etc.
1. The scheme accepts cover from 18 years and above for all dependent persons.
2. The whole family is secured if one has dependents.
3. It is cheap for everyone to afford.
1. In the case of a terminal illness, that is under cover it will not cater for full medication.
2. The cover is limited to diseases covered i.e. this scheme does not include all terminal illness.
3. Not every hospital is accredited to use the plan thus leaving out a cross-section of people who visit private hospitals.
The National Hospital Insurance Fund has helped many individuals and especially in government or other accredited hospitals settle their bills. It is good for every Kenyan to understand that this medical scheme is affordable and of high essence towards one's health in case of any illness.
All people in the informal sector should be encouraged to enroll in the program because it will sort out their medical issues when the need arises.