List Of Hospital Categories Covered By NHIF In 2022

List Of Hospital Categories Covered By NHIF In 2022

NHIF is a Kenyan government based national medical insurance scheme targeted towards the employed and self employed in the provision of both inpatient and outpatient services through various benefit packages which include;

NHIF Inpatient Benefit PackagesNHIF Outpatient Benefit Packages
ConsultationsGeneral practitioner consultations
AccommodationLaboratory investigations
Nursing CareDaycare procedures
Laboratory testsDrugs and Dispensation
Radiology examsHealth education
Physician's feesDrug and substance abuse
Operating theater chargesRehabilitation and physiotherapy services
Prescribed medications
Dressings and Maternity

Despite NHIF being a national scheme providing the above services, there exists a category of members who receive additional enhanced packages than that of the national scheme.

Such members usually consist mostly of civil servants enrolled in the managed schemes whereby employers have negotiated for better services.

However, membership in the managed schemes is also biased per job group therefore it is not a constant factor that all members enjoy the same services.

List Of Hospital Categories Covered By NHIF

Currently, there are 3 categories of hospitals covered by NHIF. These include;

i) Category A : Government Hospitals

Hospitals under this category do not charge out of pocket payments since NHIF fully caters for ALL admissions as long as the covered member is fully current with NHIF contributions.

Members in the national scheme as well as members in managed schemes can access hospitals under this category.

ii) Category B : Medium-Cost Private Hospitals

Hospitals under this category may require co-payments to be made for certain services offered. Members in the national scheme can access select hospitals under this category.

Members in managed schemes can also access services from category B hospitals.

iii) Category C : High-Cost Private Hospitals

Similar to category B, these hospitals also require out-of-pocket payments for some of the services rendered. Members in managed schemes can access services in this hospitals.

Therefore, within the three (3) categories mentioned above, members can therefore choose the hospitals to seek treatment for inpatient and outpatient services.

Click here for a list of Inpatient Hospitals
Click here for list of Outpatient Hospitals
Click here for list of Civil Servant Hospitals



Categories: NHIF

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