The Ministry of Health (MoH) on Friday, August 30, released the new Social Health Insurance Fund (SHIF) tariffs, outlining the benefits package ahead of the rollout.
Earlier in July former Health CS Susan Nakhumicha said that SHIF had introduced 17 additional benefits which Kenyans did not access under the NHIF Supa Cover.
Health Cabinet Secretary Dr. Deborah Barasa while leading stakeholders at the National Validation Forum confirmed that the Linda Mama program for expectant mothers will be incorporated and enhanced to sustain the progress in reducing maternal mortality rates in Kenya.
In the new SHIF tariffs, the amount for mothers undergoing normal delivery has been increased to Ksh. 10,000, while those delivering through C-section will receive Ksh. 30,000 in coverage.
SHIF Tariffs
Furthermore, patients with diabetes seeking outpatient services in Level 4 to 6 facilities will receive coverage of up to Ksh4,300. Those dealing with hypertension will have a Ksh2,850, cover, while patients with sickle cell anemia will receive Ksh 6,800 per year.
Diagnosis, staging, and treatment of cancer have a coverage limit of up to Ksh400,000 for various oncological services, which include chemotherapy administration, PET scans, CT scans, MRIs, radiotherapy, and brachytherapy, among others.
Also Read: Govt Issues Directives to Hospitals Countrywide Ahead of SHIF Rollout
Additionally, tariffs for the management of kidney failure in Level 3-6 facilities will range from Ksh10,650 for hemodialysis and hemodiafiltration services per session and a Ksh85,200 monthly fee for peritoneal dialysis.
Inpatient services in Level 4 to 6 hospitals will have a limit of admission of up to 180 days per household, with tariffs set at Ksh3,360 for Level 4, Ksh 3,920 for Level 5, and Ksh. 4,480 for Level 6.
Meanwhile, two years after the rollout, those who lose their loved ones will receive coverage of Ksh3,000 for embalming and Ksh500 per day for body storage for up to 5 days before burial.
About the SHIF and How to Register
The Social Health Insurance Act No. 16 of 2023 was enacted on the October 19, 2023, and commenced on the November 22, 2023.
Kenyans are required to contribute 2.75 per cent of their income towards SHIF.
Those without formal employment will make payment for the health insurance through a different payment system, contributing Ksh300 every month.
The registration to SHIF can be done through self-registration by use of USSD code *147# or via the online platform on www.sha.go.ke.
All NHIF branch offices across the country will also be used as registration centers, in addition to support by Community Health Promoters at villages.
The deadline for SHIF rollout is set for October 1, 2024, while deductions are expected to commence on November 22, 2024.
Also Read: How to Apply for SHIF: Step by Step Guide
Court Ruling on New Health Model
The High Court in July declared SHIF along with the Primary Health Care Act and the Digital Health Act unconstitutional
A three-bench judge ruled that there was no public participation in coming up with the new healthcare program, therefore it did not adhere to the law.
They further gave Parliament 120 days to correct the law establishing it.
However, the court later suspended its decision to nullify SHIF laws for 45 days after the Attorney General’s office argued that nullification would create a void in the health sector.
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