There is no doubt that an unexpected illness could end up draining your resources as your cover your own medical expenditure. However, with the NHIF insurance card, you may not need to call for a harambee or sell your assets to meet your medical bills.
The card attracts 500 shillings per month to cover for the whole family including unlimited number of dependents.
Additionally, NHIF is working with private hospitals to avail various surgical packages. These include
1. Minor Surgeries
2. Major Surgeries
3. Specialized surgeries
The packages are strictly provided on pre-authorization basis.
Below is the procedure to get the approval:-
NHIF requires that the patient information is submitted to any NHIF branch either by the member or next of kin for approval.
The documents required for these are as follows:-
1. NHIF preauthorization from completed both by the doctor and patient (check NHIF website).
2. Proforma invoice/ quotation and any relevant treatment documentation from the admitting hospital.
3. Copy of patients ID card
4. Copy of patients NHIF card
The approvals are done in less than 24 hours and can be collected by the next of kin to be presented to the admitting hospital.
Additionally, outpatient services like Radiology – CT Scan, MRI, as well as Chemotherapy, Dialysis, Radiotherapy, monthly clinic check-up for patients with cancer and other non-communicable diseases  are being paid for by NHIF.
Below are some points to note;
• Other than the NHIF cards, the ID cards can also be used to access services offered by NHIF.
• The indicated services will be paid by insurance less the NHIF rebate.
• One can access the above services even though they have not chosen the said hospitals for their outpatient services
This comprehensive in-patient health cover has been introduced for NHIF contributors and their dependants. The actualization of this package is a culmination of continued reforms at NHIF. Such reforms include efficiency, arising from decentralization of NHIF services and continued partnership with health providers on enhanced quality services to all members.
To enhance these benefits, NHIF has contracted hospitals under three Categories; A, B and C, to provide this in-patient medical cover and partial cover for surgical cases in some of these hospitals. Our members are at liberty to attend hospitals under any category.
Under Category A (government hospitals), members would be able to enjoy full and comprehensive cover for maternity and medical diseases including surgery. In short, they will not need to pay for anything on admission provided they are fully paid up members of NHIF. Members admitted under contract Category B (private and mission) hospitals will enjoy full and comprehensive cover but where surgery is required, the contributor may be required to co-pay.
Those visiting facilities contracted under Category C (private) will continue with the current system where NHIF pays specified daily benefits under the current arrangements. NHIF will continue to negotiate with other health providers not appearing in the list below to determine which category of contract they will sign.
Members will be informed of additional hospitals as and when they sign the contracts.
