The National Hospital Insurance Fund has introduced new rates for various types of surgeries.
The fund will now pay a maximum of Sh500,000 to cover specialised surgeries done only in level five and six hospitals. 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 rates were approved yesterday by the fund’s board, chaired by Mohamud Ali. He said such payment 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,” Ali said at the NHIF offices yesterday.
For minor operations carried out 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. Ali said the rates will take effect immediately they are gazetted.
“We will send the new rates to the Attorney General this week. We expect them to be gazetted immediately,” he said. The AG’s office usually gazettes such notices within 14 days.
Acting chief executive Geoffrey Mwangi said the rates also apply to mission and private health facilities accredited by the fund.
The rates come a year since the fund increased premiums paid by members. 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 rakes in Sh2.3 billion every month from these contributions.
The NHIF announced the first raft of new rates to reflect the higher income, in January this year.
