Sunday, March 26, 2023

NHIF to stop paying for cancer, diabetes, kidney at private hospitals

NHIF Chronic Diseases Cover: Kenyans with chronic diseases such as cancer, heart disease, and kidney disease may no longer get the services of NHIF at private hospitals. This follows a new legislation plan that will see National Hospital Insurance Fund (NHIF) stop paying for treatment of chronic diseases in private hospitals. This plan is aimed at reducing the payments NHIF pays out. Kenyans under the NHIF will now only get treatment for these diseases at government hospitals.

“A beneficiary with chronic illness shall access treatment for chronic illness from public health care providers only,” says the new regulations by the NHIF state.

Kenyans earning above Sh. 100,000 to pay NHIF Sh. 1,700 to Sh. 8,500

The new regulations come at a time when renal dialysis, major surgeries and diagnostics tests such as MRI and CT-scans top the list of benefits that the NHIF has targeted for cuts in a bid to reduce payouts.

The NHIF has also raised the alarm over the rising number of patients with chronic illnesses from the informal sector who are joining with the aim of easing their medical bills. Currently, NHIF’s lowest paying members pay Sh. 500 monthly, with those with chronic diseases receiving benefits of nearly Sh. 1 million per year, underlining the burden to the fund.

NHIF members are entitled to two weekly sessions of dialysis that each costs Sh. 9,500, pushing total annual payment per patient to an average of Sh. 960,000. The fund had accredited 1,619 private health facilities in the year to last June, which represents 21 percent of the total health facilities.

At the same time, Kenyans who earn above Sh. 100,000 will soon start to pay between Sh. 1,700 and Sh. 8,500 every end of the month to the National Hospital Insurance Fund (NHIF). This is according to fresh regulations by the national health insurance provider that will guide new NHIF rates.

According to the regulations, you will pay a minimum of 1.7 per cent if you earn Sh. 100,000 flat. This will however increase according to your pay up until the Sh. 200,000 mark. This means that a Kenyan earning Sh. 100,000 and a Kenyan earning Sh. 199,999 will both pay a rate of 1.7 per cent to the NHIF. Previously, employees who are earning over Sh. 100,000 have been paying a fixed monthly contribution of Sh. 1,700.

Under the new regulations, those who earn Sh. 200, 000 will see their rates double to Sh. 3,400 per month. Those who make Sh. 500, 000 will cough up Sh. 8,500 every month.

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