The Social Health Authority (SHA) is Kenya’s universal public health insurance scheme and has been in place since October 1, 2024, when it replaced the National Health Insurance Fund (NHIF).
Coverage applies to all residents, with eligibility granted upon registration without exclusions based on age, income, or social status.
Under the SHA, contribution rates are structured based on employment status, with defined minimums and payment channels.
For formal employment, the employee and employer each contribute 2.75 percent of the employee’s gross salary, bringing the total contribution to 5.5 percent. A minimum monthly contribution of Ksh 300 applies.
In the informal sector, members pay a flat rate of Ksh 300 per month, which has been revised from the previous NHIF rate. This contribution covers the member and registered dependents under one account.
Self-registration for informal sector members is available through the USSD code *147# or via the official mobile application, enabling enrollment and payment management.
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SHA Eligible Groups
The social health insurance is available and eligible to:
- All Kenyan citizens, regardless of age or income
- Legal residents, including non-citizens with valid permits or refugee identification
- Formally employed individuals through employer deductions
- Self-employed and informal sector workers, such as traders and boda boda operators
- Students registering individually or through institutions
- Vulnerable and indigent persons supported by government programs
- Domestic and casual workers under the employer’s responsibility
Breakdown of the SHA Health Benefit Package
The SHA benefit package under the “Bima Bora, Afya Nyumbani” framework outlines a structured set of health services with defined coverage limits across multiple categories.
Outpatient care is listed as unlimited, allowing registered members to access services without a cap on visits. Inpatient services are covered for up to 180 days, with a daily rebate applied within the approved limits.
The package includes high-value treatment coverage, with benefits reaching up to Ksh 1.12 million under specified categories.
Oncology services are covered up to Ksh 800,000, providing support for cancer-related treatment.
Renal dialysis is provided at a rate of two sessions per week or up to eight sessions per month, depending on patient needs. Intensive care unit (ICU) support is set at a daily rebate of Ksh 28,000 for a maximum of 12 days.
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Emergency medical services are covered free of charge for the first 24 hours. Diagnostic and imaging services, including CT scans, MRI, PET scans, angiography, and ultrasound, are included within the package.
Maternity care has a cover of upto KSh 30,000. Overseas treatment is also provided, with support capped at Ksh 500,000 for eligible cases requiring care outside the country.
Mental wellness services are included in the package, with inpatient care covered for up to 180 days under a daily rebate system. Rehabilitation services are also included, with support of up to Ksh 67,200.
The SHA package specifies that there are no exclusions based on pre-existing conditions and no age limit for eligibility.
Members can access support through the toll-free line at 147 or by visiting the SHA offices and official platforms for additional information.
