What are the Benefits of NHIF?

Many benefits of NHIF exist. The National Hospital Insurance Fund (NHIF) is a Kenya government state corporation with a mandate to provide health insurance to Kenyans.

To register for NHIF, click here

What are the Benefits of NHIF, In-Patient?

All services provided by doctors to an NHIF member at any NHIF accredited hospital upon admission in that hospital will be covered by the insurance.

The insurance will cater for hospital bed charges, diagnostic, nursing care, laboratory services, and other medically necessary facilities.

It also covers the physician’s fee, surgery fee, anesthetists’ fee, physiotherapy fee, operating theater charges, and specialist consultations. What is more, it covers, all drugs administered, dressings, and medicine prescribed by doctors for the in-patient use.

NHIF covers for dialysis at 2500 KES per session at the selected hospitals countrywide.

The insurance caters for the services in private hospitals and other high cost hospitals on a co-payment basis.

What are the Benefits of NHIF, Out-Patient?

All necessary services provided to a member in any NHIF accredited hospital he/she selected for the out-patient services will be covered by the insurance.

The outpatient services include;

1. Consultation charges
2. Drugs administered
3. Laboratory services
4. Dental health care services
5. Nursing and midwifery services
6. Minor surgery services
7. Radiology
8. Physiotherapy
9. Occupational therapy
10. Optical services
11. Referral for specialized services and any other benefit approved by the insurance board.
12. Maternity and reproductive health services.

The insurance will cater for both normal delivery and caesarean section (CS) delivery in all government hospitals, mission hospitals (Majority) and some private hospitals

For reproductive health, the insurance will cater for family planning services. The insurance DOES NOT cover for any fertility treatment. These type of benefits do not include the member’s dependents, only a declared spouse.

Group Life Benefits- NHIF Benefits After Death

NHIF pays death benefits when a member dies when the service subject provides receipt of full and well documentation.

Last Expense Benefits

NHIF covers for all death or rather funeral expenses upon the demise of a member. The client shall notify the insurance company of the death and the insurance will make arrangements on the specified amount for the members’ send off.

Ex-Gratia Benefits

Ex- gratia is the money you would receive from your employer as termination payment when you have left the employment.

Any member will enjoy the benefits but NHIF will not be held responsible of the ex-gratia payments upon its limits being exhausted.

What are the challenges of NHIF?

As much as there are benefits of NHIF, below are some of the challenges faced by NHIF members:

1. There is a prolonged registration process.
2. Poor quality health services delivered.
3. Most hospitals, especially private facilities, will favor those paying cash than those using NHIF

Finally, to enjoy benefits of NHIF, please ensure you make payments on time without delays.

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