What You Need to Know About NHIF Coverage in Kenya

The National Hospital Insurance Fund (NHIF) provides health insurance to people in both the formal and the informal sector. For people in the formal sector, NHIF is compulsory. The NHIF enables people to access medical services at any time without having to worry about the cost. The medical insurance is now catering to the needs of people in the informal sector, ensuring that all Kenyans can access the insurance cover. NHIF caters for all groups in Kenya such as Civil Servants and it has a subsidiary program for the poor, elderly people and those living with disabilities.

On the 12th December 2018, President Uhuru Kenyatta declared Universal Health Coverage (UHC) to be a national priority in Kenya, as part of his ‘Big Four Agenda’ for national sustainable development. Universal health coverage is a government’s initiative to provide quality health services to all citizens regardless of their income status. Currently, Kenya is not yet among the countries that provide universal health coverage around the world. So, is healthcare free in Kenya? In public hospitals, healthcare is free for some select services such in-patient treatment, maternity care, and simple diseases such as flu and common cold.

Features of NHIF

This insurance scheme is affordable and has the following features:

  • It does not exclude any medical inclusion apart from cosmetic procedures
  • It does not have an upper age limit
  • It does not limit one on the number of declared dependants

NHIF Registration

You can register for NHIF both online and offline. Those eligible for the NHIF scheme are persons who have attained the age of 18 years and have a monthly income above Ksh 1,000 per month and Ksh 12,000 annually either from salaries or self-employment. You can always check your monthly contributions dues.

Read: Affordable Medical Insurance in Kenya

NHIF Registration Requirements

Kenyan citizens should avail the following documents during NHIF registration.

  • A copy of the National Identity card including that of the spouse where applicable
  • Colored passport size pictures for the spouse and dependants where applicable
  • Original and copies of birth certificates for the dependants
  • A copy of employment letter from the employer (excludes those in self-employment)

Foreign residents and students should avail the following documents during the registration process.

  • Copies of passport and work permit where applicable
  • Colored passport photo size including that of the spouse and dependants where applicable
  • While using the offline option, you need to download and fill in the membership forms from NHIF website. Then submit the filled forms together with the required amount to the NHIF branches conveniently located countrywide.

Can I register for NHIF online? Yes, NHIF Kenya self service portal allows Kenyans to register for NHIF online.

For NHIF Kenya online registration, follow these simple steps.

  • Visit NHIF self service portal
  • Click on register online
  • Locate “Employer, Employee or Self Employed” tab from the menu and click on it
  • Select of you are a Kenyan or an alien
  • Fill in all the required fields
  • Attached scanned copies of your ID/Passport/Alien ID and passport photo size
  • If you are married, attach a scanned copy of your marriage certificate
  • Click Save to apply

How to Reactivate NHIF Account

Can I pay NHIF through M-Pesa?

  • Apart from paying through the bank, you can pay through Mpesa using NHIF Mpesa paybill number 200222
  • How to NHIF via Mpesa: 1. Go to your MPESA menu and select Lipa na M-PESA. 2. Choose Pay Bill and enter Business no (200222). 3. Select Account no and enter contributor’s National ID Number. 4. Enter amount (KES 500.00 per month) 5. Enter your MPESA Pin 6. Confirm all details are correct then press OK

To reactivate your account, you only need to send Ksh 1,500 through M-Pesa to NHIF pay bill number 200222. Use your National ID as the account number. You will have an active membership and you will start enjoying the benefits after two months.

How Does NHIF Work?

The NHIF is seeking to ensure that all Kenyans enjoy comprehensive in-patient and out-patient cover from any unpredictable situations and medical bills. It understands that most Kenyans are detained in hospitals for lack of funds to pay for their medical bills. Others are forced to sell their assets to raise huge sums of money to offset their medical expenses.

People in the informal sector can voluntary join the insurance scheme by contributing Ksh 500 every month to NHIF for every member. Members of the NHIF are issued a membership card which they are expected to present when they visit a hospital covered by NHIF. Doctors will attend to you and you will access medical services until you leave the hospital. The hospital is responsible for making a claim to the NHIF to get reimbursed for the expenses you spent.

There are over 400 accredited health facilities in Kenya, meaning that there are high chances that NHIF covers the hospital that you will visit. NHIF stands out compared to other insurance covers since it does not discriminate when it comes to diseases. It caters for all the diseases. Also, when patients visit private hospitals, they can share the cost with NHIF.

How to Confirm NHIF Hospital

Members can check NHIF hospitals every quarter by dialing the NHIF USSD *155# or by downloading NHIF ap available for Android and iOS or through NHIF self-help portal on the website.

What are the Benefits of NHIF Membership?

There are many benefits that NHIF registered members enjoy. Some of them include the following.

  • In-patient covered for the declared spouse and dependants
  • Provision of health services to member and dependants
  • Wide range of health facilities are NHIF covered including some private facilities

Make sure that you register for the insurance cover to ensure that you enjoy all the health benefits. It will cover you from any health uncertainties and unpredictable catastrophes.

How can I contact NHIF? You can contact NHIF through the toll-free number 0800720601 or customercare@nhif.or.ke

More Information

Vincent is a writer and researcher with an interest in finance, banking, startups, and remittance. He holds a Bachelors degree in Applied Statistics with computing. He founded Nexin Startups, an online platform offering startup advice to investors and entrepreneurs. Read more about us and our authors.