NHIF can’t pay for infertility treatment, says it’s costly and tricky

NHIF building. Duncan Ndotono
NHIF building. Duncan Ndotono

The National Hospital Insurance Fund has said it cannot cover infertility treatment.

NHIF CEO Geoffrey Mwangi yesterday said this is “unfortunate”, but infertility treatment options are expensive and some have very low success rates.

Mwangi said he has met different groups representing people with infertility and tried to explain “the situation the Fund finds itself in”.

“At the moment, we are unable to cover that. It’s very expensive. From an actuarial point of view, it’s very challenging,” he told the Star.

The survey on magnitude, causes, management and challenges of infertility says 11.9 per cent of Kenyans have infertility problems.

Last month, NHIF added infertility treatment benefits for civil servants, but explained that their cover is different from the national cover, as the government pays additional cash so civil servants enjoy the extra benefits.

“For civil servants, we pay, but it’s because they have a different scheme. Nationally, it becomes a very tricky affair. We are not yet there,” Mwangi said, adding that some forms of infertility cannot be classified as diseases.

NHIF has about 20 million beneficiaries, including about 6.7 million principal members.

It pays for a wide range of benefits on the ordinary scheme, including heart surgeries and cancer treatment.

However, the two packages must be preauthorised.