NHIF beneficiaries will no longer be required to choose an outpatient health facility for healthcare services, chief executive Geoffrey Mwangi has said.
He said patients will from this month be able to access any hospital they prefer from a list provided by the fund.
“In line with these changes, members will no longer co-pay as was the case previously and will continue enjoying the same benefits package,” Mwangi said in a statement.
This means NHIF members will walk in and walk out of the facilities fully treated at the cost of NHIF without making additional payments.
“Members shall be informed upon visiting the facility the arrangement for healthcare delivery as engaged by NHIF,” Mwangi said.
The changes allow for portability of services and will apply to both members of the national scheme and managed schemes.
NHIF registers all eligible members from both the formal and informal sector.
It is compulsory to be a member for those in the formal sector while those in the informal sector and retirees, membership is open and voluntary.
Membership is open to any Kenyan aged 18 and above with a monthly income of over Sh1,000 for those in the formal sector.
The scheme has reached a national coverage of about 24 million beneficiaries which includes the contributors and their dependents.
The number of principal contributors stood at 6.5 million by June this year.
NHIF service providers must first be accredited and recognized by the Fund before being allowed to offer services to NHIF members and claim reimbursements thereof.
Mwangi urged facilities that are yet to sign the contract to do so saying those who had not signed on November 1 should not offer services.
He said NHIF members can access the designated list of contracted hospitals and declared healthcare facilities by visiting any NHIF service point.
They can also call the toll free service line on 0800-720601 or get information via NHIF website and social media pages.
“The Fund is responding to the needs of its beneficiaries and at the same time adapting to the changing market dynamics while promoting the aspiration of universal healthcare coverage with a view to facilitating access to affordable, sustainable, equitable and quality social health insurance,” Mwangi said.
Read:
Also read: