June 18, 2024

MoH publishes services that will be offered for free under the new health insurance SHIF

3 min read
MoE publishes services that will be offered for free under the new health insurance SHIF

Ministry of Health publishes proposed tariffs for treatment (services) under the Social Health Insurance Fund (SHIF)

Ministry of Health publishes proposed tariffs for treatment (services) under the Social Health Insurance Fund (SHIF).

Kenyans with SHIF insurance policies will be able to access six free services at SHIF-accredited hospitals in the country according to a new document published by Health Cabinet Secretary Susan Nakhumicha.

Among the services Kenyans will be able to access include; access to Antiretroviral (ARV) treatment, HIV testing and follow-up tests, family planning, antimalarial medication, and testing.

Anti-tuberculosis and immunization services for children will also be offered for free.

“ARVs, antimalarials, anti TBs, and associated tests, family planning commodities, and KEPI vaccines will be provided at public facilities and faith-based & private facilities that report to the health information system,” read the guidelines in part.

Tariffs for other medical services

On the other hand, the Ministry also released guidelines and tariffs for common services such as outpatient and inpatient.

The tariff for outpatient services was put at Ksh2,000 with a limit of four visits per person in a year.

Outpatient services include; consultation, diagnosis, and treatment, prescribed laboratory, and investigations, and basic radiological examinations including X-rays, ultrasounds, prescription, drug administration, and dispensing.

On the other hand, in-patient services offered at Level 4-6 facilities will be charged at different rates depending on the facility’s categorization.

For instance, at Level 4 facilities, in-patient services will be charged at Ksh3,500 while the tariff for Level 5 facilities will be Ksh4,000.

At Level 6 health facilities, the inpatient tariff was proposed at Ksh5,000.

The scope of inpatient services includes hospital accommodation charges, meals, and nursing care in a general ward bed.

“Inpatient services shall include management of disease/condition while admitted and that includes intra-admission consultation and reviews by both general and specialist consultants, laboratory investigations, medical imaging, procedures, and medication,” read the report in part.

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Normal delivery and essential newborn care will be charged at Ksh11,200 while cesarean section and essential newborn care will be charged at Ksh32,600

“SHIF maternity services will be accessed by members and their dependents with up-to-date membership.

“In case of peripartum and postnatal complications beyond 48 hours for normal deliveries and 72 hours for CS deliveries, then per diem rate takes effect. All claims in this category will have to undergo surveillance,” the Ministry proposed.

Meanwhile, for the preservation of bodies in mortuaries, the cover will be limited to 5 days at a rate of Ksh500 per day.

Kenyans have been asked to give their view on the charges and submit their proposals before June 17.

“The comments, views, representation and any written memoranda may be forwarded to the Office of the Cabinet Secretary, Nairobi; hand-delivered to the Office of the Cabinet Secretary at Afya House 7th Floor, Nairobi; or emailed to regulations@health.go.ke; to be received on or before June 17, 2024, at 5:00 pm. 

“Additionally, there shall be physical and virtual meetings for public consultations and stakeholder engagement on the above draft Tariffs. The Ministry and Social Health Authority shall communicate the dates and venues for the physical and virtual public participation,” the CS advised.

Salaried Kenyans are expected to commence payment of 2.75 percent of their salaries to the Social Health Authority (SHA). Those with an income will pay the same rate.

Unemployed Kenyans will pay a minimum rate of Ksh300.

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