NHIF chief executive Geoffrey Mwangi. FILE PHOTO | NMG
Summary
- The fund Wednesday said it will no longer be a requirement for members to receive outpatient services in a facility they had initially selected.
- This means that members will be free to access more than 2,000 hospitals accredited to the NHIF including the high-end facilities like Aga Khan hospital, Nairobi Hospital and Karen Hospital.
- Previously members were restricted to one hospital.
National Hospital Insurance Fund (NHIF) members can now access
outpatient services from more than 2,000 hospitals and not a single
facility in changes that will see visits to top facilities like Nairobi
Hospital, Aga Khan and MP Shah limited.
The fund
Wednesday said it will no longer be a requirement for members to receive
outpatient services in a facility they had initially selected.
This
means that members will be free to access more than 2,000 hospitals
accredited to the NHIF including the high-end facilities like Aga Khan
hospital, Nairobi Hospital and Karen Hospital.
Previously members were restricted to one hospital.
“I
have come across several complains where a beneficiary travelled and
became ill and he/she cannot be treated because they did not choose the
nearby facilities,” NHIF chief executive Geoffrey Mwangi said yesterday.
“Capping
has to be there to ensure sustainability as it helps in reducing
wastage or unnecessary visits. Limits are pegged to the contributions
made.”
Formal sectors workers contribute between Sh150
and Sh1,700 monthly depending on their income to the fund while the
self-employed pay Sh500.
Private insurers put cash limit on outpatient services.
NHIF will provide the finer details of the outpatient service today.
“In line with these changes, members will no longer co-pay as was the case previously and will continue enjoying the same benefit package,” said Mr Mwangi.
“In line with these changes, members will no longer co-pay as was the case previously and will continue enjoying the same benefit package,” said Mr Mwangi.
This means the members will not be required to make cash payments on top of the NHIF share in the outpatient services.
NHIF
last month added 204 public, private and faith-based hospitals and
dispensaries to its list of accredited facilities, offering Kenyans more
places for accessing healthcare.
The move comes amid a
prolonged nationwide nurses’ strike that has seen more than 50 per cent
of public health facilities remain closed since June, causing suffering
and deaths, especially to hundreds of mothers during childbirth.
“We
are geared towards providing more services and the more the hospitals
the more the access to quality healthcare,” Mr Mwangi said.
Out of the new total, 18 facilities will cover eye, radiology, dental and laboratory services.
In August, NHIF begun a crackdown on hospitals making fake claims.
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