NHIF has introduced new benefits for members covering the cost of most surgeries.
The National Hospital Insurance Fund will now pay a maximum of Sh500,000 for specialised surgeries done only in level five and six hospitals.
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For operations classified as “major”, the fund will pay a maximum of Sh130,000 in level five and six hospitals.
But if the 'major' operation is carried out in level three or four hospitals, the fund will pay a maximum of Sh80,000.
The new benefits were approved on Monday by the fund's board chaired by Mohamud Ali.
He said such payouts will need to be approved first before a member goes for the operation.
“This will deal with major, minor and specialised surgeries including cancer surgeries,” he said at NHIF offices.
For “minor” operations conducted in level five and six hospitals, the fund will pay a maximum of Sh40,000, and a maximum of Sh30,000 for level three and four hospitals.
Level six denotes referral hospitals like the Kenyatta National Hospital while the former provincial hospitals (now county hospitals) are level five.
Other county and Subcounty hospitals fall in level four while dispensaries are level three.
Ali said the new benefits will take effect immediately they are gazetted.
“We will send the new rates to the attorney general this week. We expect them to gazetted immediately,” he said.
The AG's office usually gazettes such information within 14 days.
Acting chief executive Geoffrey Mwangi said the benefits also apply to mission and private health facilities accredited by the fund.
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The new benefits come one year since the .
The highest monthly contribution is now Sh1,700 for people earning a monthly salary of Sh100,000 and above.
Those earning between Sh12,000 and Sh14,999 contribute the lowest monthly premium of Sh500.
The fund now rakes in Sh2.3 billion every month from these contributions.
NHIF announced the first raft of new benefits to reflect the higher income, in January this year.
The fund now pays Sh25,000 per session for cancer chemotherapy, Sh18,000 for radiology, and Sh500,000 for kidney transplants, up from Sh200,000.
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In January, the fund also increased the daily rebate payable to health facilities offering in-patient services.
NHIF members now access kidney dialysis in accredited facilities to a maximum of Sh10,000 per session, a 300 per cent increase from the previous Sh2,500 a session.
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The new rate for normal delivery was also raised to Sh10,000 up from Sh6,000, a 67 per cent increase. Cesarean deliveries were also bumped up to Sh30,000 up from Sh18,000, a 67 per cent increase.
Since the fund increased its rates in April last year, the number of million principal members has risen to 6.5 million.