The UHC
Universal Health Coverage (UHC) rolled out by the Ministry of Health and National Hospital Insurance Fund (NHIF) presents an opportunity to ensure thatthe people of Kenya have access to the health services they need without suffering financial hardship. The key mandate of NHIF is to mobilize andregister members, collect contributions, and pay health insurance benefits based on the various packages that NHIF has developed for Kenyans.
We Cushion Kenyans from
NHIF is working under the guidance of the Ministry of Health (MoH) in the UHC scale-up, which presents an opportunity to secure Kenyans access to quality health services without suffering financial hardship. The spirit of UHC is that every Kenyan, regardless of who they are or what they have, can access a hospital and get treatment without suffering financial hardship. However, this means that Kenyans need to equip themselves with health insurance to avoid paying out of pocket, which would lead to poverty.
Unpackaging The
The benefits package Kenyans can access under UHCis dubbed the “UHC Supacover” Benefits package.The principle of UHC is that those who can pay should pay and those who cannot be identified and supported. The Government of Kenya has supported the initial 1 million vulnerable families of those identified in the first rollout phase. Members can access the following packages under the UHC Supa Cover:
01.
Inpatient Benefit Package
Our Inpatient Cover under the National Scheme Cover dubbed ‘The UHC Supacover‘ is available to all eligible Members with their dependants. The benefit package includes: hospital stay with health care diagnosis, procedure and treatment including Consultations and specialist doctor’s fees, bed charges, Nursing care, diagnostic laboratory & radiology investigations, prescribed medications and dressings.
General Consultation
Daily Hospital Charges
Nursing Care
Physician’s, surgeon’s, anesthetics’ or physiotherapist’s fees
Operating theatre charges
Prescribed drugs/medications and dressings
Specialist consultations or visits
Prescribed diagnostic laboratory or other medically necessary services
How To Access The Inpatient Benefit Package
Any active NHIF member will be required to visit any hospital empanelled by NHIF that offers the inpatient benefit package.
Hospital Listing
02.
Outpatient Benefit Package
Our Inpatient Cover under the National Scheme Cover dubbed ‘The UHC Supacover‘ is available to all eligible Members with their dependants. They include: Consultation with a GP, laboratory and radiological investigations including X-rays and ultrasounds, day-care procedures, drugs & dispensation, health education, mental and behavioural health services, counselling, physiotherapy services, Antenatal & Post Natal care, immunization/vaccines as per KEPI schedule, anti snake venom and anti rabies.
General Consultation
Laboratory and investigation including X-rays and ultrasounds
Diagnostics and treatment of common ailments
Drugs & dispensation
Management of chronic ailments (HIV/AIDS, Diabetes, Asthma, Hypertension, cancer)
Health and wellness education/healthcare counselling such as Screening for conditions e.g Cervical and prostate cancer.
Anti snake venom and anti rabies.
Physiotherapy services
Family planning,midwifery,ante-natal and post-natal services
Physiotherapy Services
Referral for specialized services
Immunization/vaccines as per KEPI schedule
How To Access The Outpatient Benefit Package
Any active NHIF member will be required to visit any hospital empanelled by NHIF that offers the outpatient benefit package.
Hospital Listing
03.
Maternity Benefit Package
Caters for pregnancy related health services: facilitation of labour, delivery through Normal delivery or caesarean section and the aftercare for the mother together with the new-born.
Consultation and treatment for both mother and child
Child birth through normal and caesarian section deliveries
Family planning services
Operating theatre charges
Prescribed drugs/medications and dressings
Specialist consultations or visits
Prescribed diagnostic laboratory or other medically necessary services
How To Access The Maternity Benefit Package
Any active NHIF member will be required to visit any hospital empanelled by NHIF that offers the maternity benefit package.
Hospital Listing
04.
Renal Dialysis Benefit Package
Covers Haemodialysis including specialist review, nursing & dialysis services, intra-care & dispensed medications, routine laboratory tests, nutrition, counselling & follow up care.
Specialists’ reviews
Nursing and dialysis services
Intra-care and dispensed medications
Nutrition
Routine laboratory tests
Counselling and follow up care
How To Access The Renal Dialysis Benefit Package
Any active NHIF member will be required to visit any hospital empanelled by NHIF that offers the renal dialysis benefit package.
Renal Dialysis Hospitals
05.
Oncology Benefit Package
Includes treatment for cancer patients using radiotherapy, brachytherapy, chemotherapy, immunotherapy, Pet Scans and other interventions as guided by the Ministry of Health (MoH).
Radiotherapy
Brachytherapy
Chemotherapy
Immunotherapy
Pet Scans
Other interventions as guided by the Ministry of Health (MoH)
How To Access The Oncology Services
Any active NHIF member can access the surgical benefit package in any hospital empanelled by NHIF.
Oncology Package Hospitals
06.
Surgical Benefit Package
All surgical procedures including transplants are covered. Cosmetic surgeries are excluded.Cosmetic surgery is where a person chooses to have an operation, or invasive medical procedure, to change their physical appearance for cosmetic rather than medical reasons. The surgical procedure benefit package includes:
Pre-operative reviews
Operations Costs
Surgeon’s and Anaesthetist fees
Nursing care
Bed charges
Prescribed medication during hospital stay and discharge
How To Access The Surgical Benefit Package
Any active NHIF member will be required to visit any hospital empanelled by NHIF that offers the surgical benefit package.
Hospital Listing
07.
Radiology Benefit Package
Includes diagnostic imaging services for MRIs and CT scans
NOTE: X-Rays & Ultrasounds are covered under inpatient and outpatient packages.
CT-Scan
MRI
How To Access The Radiology Benefit Package
Any active NHIF member will be required to visit any hospital empanelled by NHIF that offers the radiology benefit package.
CT-Scan Hospitals
MRI Hospitals
08.
The Mental & Behavioural Health Benefit Package covers common mental disorders (including depression and anxiety), severe mental disorders (including psychosis, schizophrenia and bipolar disorder); Neurological disorders (such as epilepsy and dementia), childhood disorders, and drugs and substance abuse disorders.
Common mental disorders (depression and anxiety)
Severe mental disorders (psychosis, schizophrenia and bipolar disorder); Neurological disorders (such as epilepsy and dementia)
Childhood disorders
Drugs and substance abuse disorders
An active NHIF member will be required to visit any hospital empanelled by NHIF that offers the mental & behavioural health benefit package.
Mental Health Hospitals
09.
Emergency Care Benefit Package
This covers road ambulance services via the Kenya Red Cross E-Plus ambulances. It caters for on-site evacuation and transfer of a sick member or their declared dependents for treatment to nearest NHIF declared hospital.
How To Access The Emergency Care Benefit Package
An active NHIF member will be required to contact E-plus through the telephone numbers 1199 (Toll-Free) or 0700395395 or 0738 395395 or the NHIF toll free line – 0800 720 601.
10.
Overseas Treatment
This benefit package covers for treatment costs pertaining to medical and surgical interventions and PET Scan Imaging, arising from a condition that warrants treatment that’s not available in Kenya.
How To Access Overseas Treatment
Member or their declared dependant must be cleared by the Ministry of Health for travel.
Overseas Treatment
