National Hospital Insurance Fund headquarters in Nairobi. Photo/FREDRICK ONYANGO
By KIARIE NJOROGE, gkiarie@ke.nationmedia.com
The National Hospital Insurance
Fund (NHIF) has introduced a surgical benefits package that will see it
cover minor, major and specialised surgeries to ease the financial
burden for members undergoing the procedures.
It will cover a maximum Sh500,000 for
specialised surgeries, Sh130,000 for major surgeries and Sh40,000 for
minor surgeries. Surgery costs were previously not covered.
The surgical package is the
latest addition to procedures covered after dialysis and cancer
treatment following the increase of premiums payable by members by the
national health insurer.
“This package will deal with
major, minor and specialised surgeries including cancer surgeries,”
Mohamud Ali, the NHIF board chairman said on Monday.
He added that this will now allow for NHIF members to be covered for surgeries like heart and brain procedures.
Many households resort to holding
fund-raisers to cater for the major and specialised surgeries and the
after-care expenses. Mr Ali said the benefits will become applicable
once they are put on the Kenya Gazette.
“The letter (for gazettement)
will go out tomorrow (today) to the Attorney- General’s chambers and we
expect that to come out in the Gazette as soon as possible. Immediately
they are gazetted,” he said.
The package is value for money
for more than two million NHIF members, whose monthly contribution rose
by up to 1,000 per cent with a thin range of benefits accruing to them.
The NHIF in April gazetted new
rates for procedures like cancer therapy, MRI diagnostic services and
kidney dialysis which saw large private and mission hospitals agree to
start offering these services.
The April rates were set after negotiations with the hospitals which had refused the initial rates arguing they were too low.
The April rates were set after negotiations with the hospitals which had refused the initial rates arguing they were too low.
The hospitals are however yet to start offering outpatient services to NHIF members as they differ on the pricing.
Members remain confined to
medical care from public hospitals and small private facilities that
have agreed to the lower capitations.
This is despite an increase in
workers’ monthly contributions to the fund from Sh320 to between Sh500
and Sh1,700 in April based on their pay scale with the promise of
enhanced outpatient benefits in both public and private hospitals.
Private hospitals have rejected
the Sh1,200 allocation that the NHIF has offered to pay as annual fee
(capitation) for every beneficiary, saying it is too little.
This has meant that patients
visiting the outpatient facilities in hospitals like Nairobi, MP Shah,
Aga Khan and Mater pay out of pocket or through their private insurance.
The statutory medical scheme collects up to Sh1.9 billion a month.
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