The Social Health Authority (SHA) has disclosed that the government will cover 39 specific treatments that are unavailable in Kenya.
Speaking during a media interview on Tuesday, September 16, 2025, SHA CEO Dr. Mercy Mwangangi revealed some of the 39 procedures the government will cater for, including the corresponding costs.
“On Friday, the Cabinet Secretary, in line with the law, will gazette a list of about 39 procedures. These procedures have been assessed by the Health Benefits Advisory Panel, which determined they are not available in Kenya. Those 39 procedures are the only ones SHA will pay for,” said Dr. Mwangangi.
She further explained that the government will only pay up to Ksh 500,000 for each of the 39 procedures, with the payment applied as a tariff.
SHA to Cater for 39 Procedures for Overseas Treatment
Among the procedures to be covered abroad are complex pediatric cardiac surgeries, pregnancy-related intrauterine transfusions, and operations such as full femur and tibia replacements, all of which cannot currently be performed in Kenya.
At the same time, the SHA CEO clarified that the government will not cover treatments that can be performed locally.
“For example, if you decide you want to go for a hip replacement in India, it is not in the list of 39. That service is only reimbursable in Kenya because we have doctors and providers who can do it here. We have put a moratorium on such cases,” Dr. Mwangangi explained.
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She added that on Friday, September 19, 2025, the government will gazette the full list of 39 procedures eligible for overseas treatment, along with the approved hospitals where Kenyans can seek care.
“We will even share the list of hospitals. Kenyans will no longer just choose any hospital without verification. We will ensure the hospitals are accredited and capable of offering these services. All this will be digitized,” Dr. Mwangangi noted.
Health CS Aden Duale Says SHA Overseas Treatment must Strictly Follow Certain Procedures
Earlier, on August 7, 2025, Health CS Aden Duale clarified that SHA approvals for overseas treatment must follow the Social Health Insurance Act, Public Procurement Act, and Attorney-General guidelines on foreign contracts. He stressed that arbitrary funding is not permitted, and a Benefits Package and Tariffs Advisory Panel (BPTAP) is finalizing the official list of eligible procedures.
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On August 17, 2025, he formally announced a 30-day suspension of overseas treatment approvals for system alignment and upgrades, urging patients to seek local alternatives.
Later, on September 11, 2025, during the launch of the Digital Health Transformation and TaifaCare Caravan in Eldoret, Uasin Gishu County, Duale reiterated that the suspension would remain in place until reforms were complete.
He also highlighted cases of abuse by cartels who referred patients abroad for profit, even for conditions treatable in Kenya.
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