The National Hospital Insurance Fund (NHIF) paid Sh5.9 billion
in members’ medical bills in the four months to October, more than half
of it going into surgeries, the agency said.
NHIF chief
executive Geoffrey Mwangi said chemotherapy, radiotherapy, dialysis and
diagnostic tests such as MRI and CT scans also made it to the list of
top claims.
“Surgeries are more expensive even if less
are done. We have over 15 minor surgeries, for instance, to cater for in
that package,” Mr Mwangi said.
Official records show
that Sh3.1 billion was paid out for specialised, major and minor
surgeries alone during the review period, easing the cost burden on
Kenyans undergoing surgical procedures in local hospitals.
Chemotherapy
and radiotherapy accounted for Sh769 million while magnetic resonance
imaging (MRI), computed tomography (CT) scan and dialysis took out Sh264
million.
The NHIF started covering surgical treatment
of up to Sh500,000 per procedure last October after signing contracts
with more than 2,000 hospitals, including the high-end private ones such
as Aga Khan, MP Shah, Nairobi and Mater.
Between
October 2016 and June 2017, the State-owned insurer had spent Sh200
million on heart surgeries alone, highlighting the growing cases of
lifestyle diseases among Kenyans.
Contributors to the fund enjoy benefits of up to Sh1.5 million for heart operation.
The
surgical package, which includes cancer surgeries and brain procedures,
is seen to constitute real value for money for the more than 6.5
million NHIF members whose monthly contribution rose by up to 1,000 per
cent early this year but with a thin range of benefits accruing from it.
The
workers’ monthly contributions to the fund rose from Sh320 to between
Sh500 and Sh1,700 in April based on an individual’s pay scale with the
promise of enhanced outpatient benefits in both public and private
hospitals.
Many households resort to holding
fund-raisers to cater for specialised treatment and the after-care
expenses. Standard inpatient payouts accounted for Sh57 million while
outpatient payouts for the same period stood at Sh2.7 million.
The
NHIF’s records also show that Sh39 million was paid to hospitals which
conducted deliveries for mothers under the national free maternity
programme – a Jubilee government flagship programme.
The
NHIF payouts for the programme last year stood at Sh28 million,
indicating an increase in the number of mothers enrolled in it.
“Registration
of expectant mothers stood at 16,519 in September, up from 12,186 the
previous month. In July we had only 10,874 mothers enrolled to the
programme but now we are covering more of them and guaranteeing quality
of care through the programme,” said Mr Mwangi.
The
NHIF pays Sh2,500 for normal delivery at health centres and
dispensaries, Sh5,000 in hospitals and Sh17,000 for referral facilities
such as Kenyatta National Hospital for arising complications.
It also covers Sh17,000 for Caesarian-section - surgical operation to help deliver a baby - in Level Four and above facilities.
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