The Ministry of Health has announced plans to review the Ksh 500,000 overseas treatment benefit package offered by Social Health Authority (SHA).
While addressing the media on Wednesday, January 22, Health Director General Dr. Patrick Amoth stated that the review was prompted by public concerns about the cost of the benefit.
“The indication initially was that you are supposed to review the tariffs and benefits after two years.
However, due to calls from Kenyans regarding their experience with SHA, the review will be done much sooner,” Amoth explained.
Government announces plans to review SHA overseas benefits
Dr. Amoth further noted that most overseas treatments cost over Ksh 1,000,000, particularly high-risk surgeries, which significantly exceed the current benefit provided by the government. He added that the Ministry of Health (MOH) had instituted measures to address the issue.
“The Cabinet Secretary and the Principal Secretaries in the State Department of Medical Services have implemented measures to ensure that the benefit package tariffs advisory panel, as envisioned in the law, is operational,” Amoth said.
Issues of discrimination within the SHA health scheme were also addressed. Reports indicated that civil servants receive better SHA package benefits than individuals working in the informal sector.
Also Read: SHA CEO Responds to Having Separate Medical Cover for Civil Servants
However, SHA CEO Robert Ingasira emphasized that the scheme is designed as an extension of the package available to all Kenyans.
“We have a separate scheme for civil servants, but the benefit I have mentioned is available to all Kenyans who are registered under SHA,” Ingasira clarified.
He further explained that the SHA scheme was gradually being integrated into the newly implemented universal healthcare system. Once complete, both civil servants and ordinary Kenyans would have equal access to benefits.
Eight weeks old baby dies after family denied overseas benefits
The authority also clarified that the transition was temporary and aimed at ensuring a smooth integration process.
“We have a separate scheme for civil servants, but the benefit I mentioned is uniform and available to all Kenyans under SHA. The civil servant’s scheme is simply an extension,” Ingasira reiterated.
The Ministry of Health’s announcement about plans to review the overseas treatment benefit comes just days after several media stories highlighted the frustrations SHA users face while trying to access the benefit.
Also Read: Baby Stuck in ICU Over SHA Confusion Dies
Concerns were also raised about the government’s overseas treatment allowance being significantly lower than the actual expenses required for such treatments.
Recently, an eight-week-old baby, who had been admitted to Mater Hospital and was denied access to the Social Health Authority (SHA) overseas treatment benefits, passed away on Tuesday, January 21, 2025.
The baby, Callum, was scheduled to undergo corrective heart surgery in India. However, according to his parents, he was unable to access the overseas treatment package provided under the Universal Health Coverage (UHC) because his parents were not public servants.
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