The National Hospital Insurance Fund (NHIF) is a Kenya government state corporation with a mandate to provide health insurance to Kenyans. The core business and mandate for NHIF is to provide accessible, affordable, sustainable and quality health insurance for all Kenyan citizens. NHIF registers all eligible members from both the formal and informal sector. For those in the formal sector, it is compulsory to be a member. For those in the informal sector and retirees, membership is open and voluntary.
Contents
NHIF members enjoy the following benefits.
Formal sector employees’ contributions are deducted and remitted to the Fund by their employers. This is done by Cheque or through E-banking. For members under the voluntary category, they pay Ksh 500 per month (Ksh 6,000 per annum). For those in formal employment, contributions are made as per their income.
The following premium rates apply:
Gross income | Monthly premium amount |
Up to Ksh 5,999 | Ksh 150 |
Ksh 6,000 – Ksh 7,999 | Ksh 300 |
Ksh 8,000 – Ksh 11,999 | Ksh 400 |
Ksh 12,000 – Ksh 14,999 | Ksh 500 |
Ksh 15,000 – Ksh 19,999 | Ksh 600 |
Ksh 20,000 – Ksh 24,999 | Ksh 750 |
Ksh 25,000 – Ksh 29,999 | Ksh 850 |
Ksh 30,000 – Ksh 34,999 | Ksh 900 |
Ksh 35,000 – Ksh 39,999 | Ksh 950 |
Ksh 40,000 – Ksh 44,999 | Ksh 1,000 |
Ksh 45,000 – Ksh 49,999 | Ksh 1,100 |
Ksh 50,000 – Ksh 59,999 | Ksh 1,200 |
Ksh 60,000 – Ksh 69,999 | Ksh 1,300 |
Ksh 70,000 – Ksh 79,999 | Ksh 1,400 |
Ksh 80,000 – Ksh 89,999 | Ksh 1,500 |
Ksh 90,000 – Ksh 99,999 | Ksh 1,600 |
Ksh 100,000 and above | Ksh 1,700 |
Self-employed (special) | Ksh 500 |
Claims are submitted by hospitals directly to NHIF after the contributors have been discharged from the hospitals. The claims are examined by the Fund to ensure validity before payment. A claim can however be rejected and the hospital informed accordingly to incorporate either the missing documents or to address the abnormalities identified. The Fund strives to pay claims within 14 days upon receipt of the claim from the hospitals. Members who opt to clear the bills with the hospital may launch a general claim directly to NHIF for reimbursement.
NHIF seeks to establish partnership with individuals and organizations to finance health insurance for indigents including orphans and vulnerable children, poor older persons, persons with disabilities and destitute families. The indigents shall be identified by NHIF or the sponsors. Enrolled indigents and their dependants shall have access to the current benefit package of inpatient cover in any of the health providers accredited to NHIF countrywide.
Here are the services covered by NHIF.
The Fund strives to accredit as many hospitals as possible so as to ensure all members access NHIF benefits whenever they are across the country. NHIF has an objective accreditation criteria and guidelines that aim to encourage hospitals towards quality improvement. Accredited organizations are those recognized by the Fund and allowed to offer services to NHIF members and claim reimbursements thereof. The contracts spell out the obligations of the health provider and NHIF.
Accreditation of a health provider takes into account the services, personnel, infrastructure and equipments among other issues that the institutions have. The level of rebate therefore corresponds to the grade after scoring the various aspects. The Fund, further contracts the health facilities to ensure they provide services comprehensively. This means that NHIF members walk in and walk out of the facilities fully treated at the cost of NHIF without making additional payments.
To register for NHIF as a member, you must meet the following requirements.
To register for NHIF as an employer or organized group, you must meet the following requirements.
You can reach NHIF using the contacts below.
NHIF Headquarters, along Ragati Road, off Ngong Road, Upper Hill, Nairobi
P.O. Box 30443 – 00100, Nairobi, Kenya
Tel: +254 20 273 1255
Tel: +254 20 273 1256
Tel: +254 20 271 4793
Tel: +254 20 271 4794
Tel: +254 20 272 2527
Mobile: +254 726 268 933
Toll Free: 0800 720 601
To register as an employer or organized group, fill in the Employers Form and drop it off at any of NHIF branches located countrywide. Alternatively, you can register online by filling in the required details on the online form and uploading the scanned copies of documents you will be asked for.
To register with NHIF as a member, fill in the Members Form and drop it off at any of NHIF branches located countrywide. Alternatively, you can register online by filling in the required details on the online form and uploading the scanned copies of documents you will be asked for.
Victor Mochere is an award winning blogger, social media influencer, literati savant, altruistic, and a netpreneur creating and marketing digital content.
This site uses Akismet to reduce spam. Learn how your comment data is processed.
Permission to use quotation from any article is granted subject to full credit of the source being given by referencing the direct link of the article on Victor Mochere. However, reproducing any content on this site without explicit permission is strictly prohibited.
We are committed to upholding our editorial standards, including accuracy. Our policy is to review each issue on a case by case basis, immediately upon becoming aware of a potential error or need for clarification, and to resolve it as quickly as possible. If you notice an error or typo that needs correction, please don’t hesitate to contact us for immediate action.
Victor Mochere brings you a daily dose of well curated up to date facts, news, opinions and important updates from Kenya, Africa and around the World.
Copyright © 2021 Victor Mochere. All rights reserved.
Copyright © 2021 Victor Mochere. All rights reserved.