National Hospital Insurance Fund headquarters in Nairobi. Photo/FREDRICK ONYANGO
By STELLAR MURUMBA
In Summary
The National Health Insurance Fund (NHIF) will start
covering surgical procedures from October 1 in a move expected to ease
cost burden on Kenyans undergoing specialist treatment at the local
facilities.
The NHIF chief executive officer, Geoffrey Mwangi said the
national insurer is finalising on guidelines to govern the new benefits.
Mr Mwangi said that beneficiaries will access the new services from all level three and above hospitals that are accredited with the NHIF.
Mr Mwangi said that beneficiaries will access the new services from all level three and above hospitals that are accredited with the NHIF.
“Besides finalising on the guidelines, we are also
signing contracts with over 2,000 facilities that are accredited with
us,” Mr Mwangi told the Business Daily yesterday during a phone
interview. “Kenyans who access the other over 4,000 low-end facilities
will also benefit from this package.”
The insurer had initially announced the surgical
benefits last month stating that it had embarked on setting up
guidelines for gazettement.
Surgery were initially not covered by the NHIF.
Surgery were initially not covered by the NHIF.
Kenyans accessing minor procedures from health
centres and other low-end facilities will enjoy between Sh30,000 and
Sh40,000 cover of their medical bills.
Major and specialised surgeries done in level
three, four and five hospitals will be catered for their bills to the
tune of Sh80,000 and Sh500,000, respectively.
The increased benefit comes a few months after the
NHIF increased premiums payable by members. It has since introduced
special packages including; foreign treatment, specialised lab test,
chronic disease, oncology and radiology. Other newly introduced packages
include drug and substance abuse, kidney transplant and renal dialysis
package.
The NHIF previously only covered maternity, inpatient and outpatient medical costs.
Enhanced benefits
The surgical package is value for money for more
than two million NHIF members whose monthly contribution had ridden by
up to 1,000 per cent with a thin range of benefits accruing to them.
The workers’ monthly contributions to the fund were
increased 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.
The new benefits will now allow for NHIF members to be covered for cancer surgeries and others 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.
smurumba@ke.nationmedia.com
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