The National Hospital Insurance Fund is a government-based, health insurance cover which aids Kenyans to access services from accredited health facilities. Therefore, as is the norm with most insurance services, there is a premium (which is Ksh. 500 per customer ) to pay to access the benefits. It accepts members from both formal and informal sectors and in recent years have been stepping up their efforts to include better healthcare to its members. Every member is obligated to remit a monthly contribution to their existing accounts. Fortunately, there is an NHIF M-Pesa paybill number which provides a hassle-free and efficient way of submitting payments.
However, you may pay your monthly contributions and penalties via their official business number or Paybill that is 200222. The entire process is similar to when accessing services for other institutions. Though, the details required are different and particular to every purpose.
Services covered by NHIF include;
- The Outpatient services such as Consultation, Laboratory, investigations, daycare procedures, drugs and dispensation, health education, wellness and counseling, physiotherapy services, immunization,/ vaccines as per the KEPI schedule.
- Inpatient services
- Maternal care such as Antenatal and Prenatal care and deliveries (Normal delivery and cesarean section)
- Reproductive health services such as Family Planning
- The Renal Dialysis
- Overseas treatment for specialized surgeries not available locally
- Rehabilitation for drugs and substance abuse
- All the surgical procedures including transplants
- Emergency road evacuation services
- Radiology imaging services that include X-rays, CT Scan, & MRI
- Cancer Treatment
Benefits of NHIF
- According to the new benefits, patients may access whatever health center they choose. The list comprises more than 2,000 hospitals.
- The Kenyans citizens needn’t copy when using their common package. Extra pay for full treatment has been abolished.
- Mostly, charges are equal and applicable to self-employed and civil servants. NHIF registers people from both sectors. Patients in the formal sector MUST be members but it’s optional but highly advisable for people in the informal sector to be members. The NHIF scheme is said to have more than 24,000,000 beneficiaries.
- The corporation provides medical cars for evacuation to every member. This service is available for people who require urgent assistance and treatment at home or road traffic incidents. You only require to use Red Cross’ free of charge hotline.
How do I log into my NHIF Account?
Follow the procedure to check your status.
- Visit the NHIF self-service portal on the browser.
- Click on the self-service option.
- Enter your phone number or email.
- Enter the password that you created during registration.
How to get NHIF account status for existing members
Using your mobile phone
To get NHIF status via the phone, compose a message starting with your National ID number and send it to 21101. You will get an immediate reply with your account details and status. This only costs Sh10.
Via the website by using an internet-enabled device, go to the official NHIF website, select the self-service portal, login in with the password you have created, fill in your personal details, and proceed to get your account’s status.
NHIF New Rules
- For the National Scheme members, the number of dependents per card to be limited to a maximum of one spouse and five children.
- Members voluntarily joining the fund will have to wait for 90 days before they start accessing NHIF services. Additionally, one will have to make a one year upfront payment within the waiting period.
- When one makes a late payment, he/ she will incur a fine of 50% of the monthly contribution coupled with a requirement to pay for one year in advance. He/she may be restricted against claiming benefits for a period of 30 days.
- The Defaulting for 12 months and above may force one to start payment afresh and may only be eligible for benefits after 90 days upon resumption of payment. A one year upfront payment might be applied and strict adherence to deadlines.
- To have access to specialized services shall be restricted to a six-month waiting period following card maturity for new members.
- Access maternity benefits will henceforth be restricted to 6-months postcard maturity for principal members or spouses declared at the point of registration.
- For both the maternity and specialized services, whatsoever dependent declared after initial registration may be subjected to a 6-month waiting period? The Newborns may, however, be exempted from this waiting period and will be considered eligible for the benefit provided they are declared within six months from the date of birth.
- For the medical inpatient and medical outpatient additional dependents might be eligible for benefit after 30 days waiting period. This waiting period of 30 days will as well apply in case of a change of spouse.
How can I Check my NHIF Account Status online
NHIF has a website where you may obtain information regarding their services and operations among other things.
To check your account online via the web, follow the procedure as follows:
- Go to the NHIF official website here, nhif.or.ke
- Sign up to the self-service portal
- You will be required to register in the case of a newcomer. This makes you be able to possess an online account with NHIF. But even you registered already, just sign in your account.
- If you are registering for the first time, make sure that you have the NHIF number, email address, and phone number.
- You will be required to fill in the prompts as needed; enter the details, save, and then submit
- Try to create your own password. You may use it every time you want to do something on the portal. Choose a password that’ll be simple for you to remember. (It is possible to retrieve a forgotten password in case you forgot)
- You have the account, now you require to log into the account and start doing what you were after.
- Check your NHIF account status online with details that show how you contribute monthly. You may as well be able to see the balances, which months you defaulted and activation among other things.
- Having finished everything with the account, you are required to log out. Don’t leave your account open as your bio would be insecure.
How to register for NHIF account online
- Visit http://www.nhif.or.ke/healthinsurance/registeronline/
- Click Self Employed on the Menu
- iii. Enter your National ID/Passport/Alien ID
- If the Provided ID Valid, the System may allow you to continue.
- Fill in all form fields.
- Attach a Scanned Copy of Your ID/Passport/Alien Id.
- Attach Passport Photo.
- If married, attach Your Marriage Certificate.
- Click Save. If you filled in all fields, the application will be submitted
- The system will notify you of the Application Status
- The system will also send a notification SMS to the Contributor’s Mobile Number
How much is the NHIF penalty per month?
For any late payment attracts a penalty that is double the principle. However, members have two options,
1.) Paying the penalty and their a/c regularized OR
2.) Not paying the penalty but instead, a/c’s may be restricted for 60 days where they may not be able to access any NHIF services.
How to check my NHIF Account payment Status
We are going to do a simple guide on how to check your NHIF account contribution status as of 2020.
- On your phone, compose a new text message with the letters ID followed by space and then your ID number e.g. ID 456475
- Send the SMS to 21101
- You may receive a reply immediately with your NHIF account contributions status.
This service costs Ksh 10 and may be used by both self-employed and employed Kenyan citizens.
How do I choose a hospital for NHIF?
For you’re to select a medical facility, please refer to the list of NHIF accredited health facilities available on the NHIF Website and NHIF offices countrywide.
To access services or benefits one MUST be duly registered by filling NHIF Registration Form (NHIF 2) and declaring their dependents.
How can I reactivate my NHIF account?
one can reactivate his/her NHIF membership and to start enjoying the NHIF Supa cover benefits by taking advantage of the amnesty extended to all previous NHIF members that stopped remitting regular contributions. The amnesty applies as follows:
- Self-employed members who have defaulted for 1- 12 months
Note that a member has 5 days from the date of paying the late contribution to complete payment of penalties.
- The Self-employed members who have defaulted for over 12 months are to be required to start afresh. Though, they may not have the option of paying penalties in order to access benefits immediately. The member will be restricted from accessing NHIF benefits for 60 days.
- You may reactivate your NHIF card by paying at least KES 1,500 to resume usage of your card.
- For all Employed members are required to get a letter from the new employer and a duly filled amendment form requesting a change.
How to check my NHIF outpatient hospital
The NHIF strives to accredit as many health care facilities as possible in order to make sure in which the cardholders access outpatient services regardless of their location. Well, how may you know the NHIF outpatient hospital that has been accredited by the fund to provide these services? The NHIF fund publishes an updated list of NHIF accredited outpatient hospitals from time to time. You may check your NHIF hospital online on the NHIF website, or you may visit any of the NHIF offices countrywide to access this list
The NHIF accredited facilities are classified into 8 regions; Nairobi, Rift Valley, Central, Western, Nyanza, Eastern, Coast, and North Eastern. You can choose your region from the above list to find the list of accredited health care facilities that are within your proximity. Cardholders may walk into any of these facilities to access outpatient services without having to worry about paying additional costs.