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 Packages||NHIF Outpatient Benefit Packages|
|Consultations||General practitioner consultations|
|Nursing Care||Daycare procedures|
|Laboratory tests||Drugs and Dispensation|
|Radiology exams||Health education|
|Physician's fees||Drug and substance abuse|
|Operating theater charges||Rehabilitation and physiotherapy services|
|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.