The Ministry of Health has revealed the allocated daily rates under the Social Health Authority (SHA) for High-Dependency Units (HDU) and the Intensive Care Units (ICU).
In a statement on Sunday, December 15, the Ministry indicated that it was addressing concerns raised by the public, especially regarding critical care services under the health coverage.
According to the statement, SHA, which came into effect in October 2024, aims to advance Universal Health Coverage (UHC) by pooling health resources and ensuring equitable access to healthcare services across Kenya.
The daily payment rates for ICU and HDU include Ksh3,360 for level 4 hospitals, Ksh3,920 for level 5 hospitals and Ksh4,480 for level 5 facilities.
“The provider payment mechanism (PPM) is a per diem rate, and the rate depends on the type of facility visited,” the statement noted.
Also Read: State House Lecturers Desperate Patient Over #REJECTSHA
Cases Where Hospital Charges Are Above Rates
Each household will have a cover limit of up to 180 days annually.
However, in cases where hospital charges exceed the specified limits, beneficiaries may need to make co-payments to meet additional costs. This cover applies equally to public, private, and faith-based facilities.
“In light of recent concerns regarding the extent of SHA coverage, we wish to clarify the framework governing SHA’s benefits and tariffs. The Ministry of Health confirms that SHA’s coverage is based on gazetted Tariffs to the Benefits, published in November 2024,
“The members will top up any amount that exceeds the above cover limit (Co-pay). The cover limit is the same for Public, Faith-based, and Private facilities,” added the statement.
Further, the Ministry highlighted its proactive measures to address challenges affecting healthcare delivery, including cancer care, renal care, maternity, and outpatient services.
“The government is currently forming a committee to review SHA tariffs and benefits under Regulation 41 of the Social Health Insurance Regulations.
“This committee will provide both short- and long-term recommendations to ensure sustainability and responsiveness to Kenyans’ needs.”
Also Read: Concern as 67% of Kenyans Express Dissatisfaction With SHA Services
State House on SHA
State House Director of Public Communications Gerald Bitok has schooled X influencer Bevalyne Kwamboka who is in desperate need of healthcare.
In a statement, Bitok responded to Kwamboka’s plea for help and allegations that the Social Health Authority (SHA) was not functioning as claimed by the government.
According to her, she had been forced to pay for treatment out of pocket despite being registered to SHIF, adding that she might undergone surgery, which will be very expensive.
“I am still in pain, and nothing can be done until I undergo a CT scan. I’m at the German Centre for the procedure. The government is lying about SHA. I’ve been paying everything out of pocket. Yes, I’m registered with SHA.”
“If the CT scan results allow for surgery, I can’t even imagine how much they’ll charge since SHA is Shit,” she stated.
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