Residents of Kiambu County have been encouraged to enroll for an NHIF Medical Insurance cover so that they are not caught up in the mix with huge medical bills when they fell ill and required medical attention.
In an interview with KNA in his office yesterday at MAPA house in Kiambu town Mr. Rex Kirimi the Senior Registrar and Compliance Officer (SRCO) advised on the importance of an NHIF Insurance Cover. The aim and focus of NHIF is to provide health financing and insurance, he said.
The officer clarified that everybody was free to register and enjoy NHIF services including those who were not permanently employed as they could save and pay for their monthly dues to the health provider.
He explained that a family cover usually covers the parents and children below the age of 18 years but also makes an exception for those over 18 up to 23 years if they are still in school. Proof that one was a student was required prior to NHIF extending their cover to such a person.
The first step of getting a cover is registration whereby the applicant fills a form at any NHIF branch and declares dependants (children, spouse and any legally adopted children that are to be covered by NHIF).
For those who are employed the medical cover is compulsory and the monthly contribution depends on the earning. Those who earn less than sh 6,000 contribute sh 150, which is the minimum. The maximum monthly contribution is sh 1,700 for those who earn sh 100,000 and above. Voluntary members pay a monthly contribution of sh 500. The young support the old, the rich support the poor and the healthy support the sick, says Mr. Kirimi.
There are several schemes in the NHIF covers including the Civil Servants Scheme, which is comprehensive meaning the entire hospital bills, is paid for by NHIF.
Karimi said the enhanced cover was customized for discipline forces. There was also the National Scheme that covers inpatients, outpatients and dialysis and surgical (all treatment) is not comprehensive meaning NHIF Covers a certain percentage of the hospital bill.
There are 3 categories of hospitals: Government Hospitals where all charges are fully paid for, Faith/Mission Based Hospitals which also offers the comprehensive package and third category is the Private Hospitals where the cover pays ratable, which means they allocate sh 4,500 per day multiplied by the number of days for inpatient services.
NHIF also covers special procedures like Heart and Kidney Transplant locally and abroad. We offer sh 500,000 for these procedures but depending on the breakdown by the hospital on different categories of treatment we may cover up to sh 2, 000, 000, says Kirimi. NHIF also covers dialysis two times per week with sh 9,500 per session.
For Civil Servants under the cover the job groups are categorized into two: Job Group A-M is given a list of all available government hospitals and they choose the ones that are most convenient for them. For those hospitals they choose there is no limit to the amount that can be covered in outpatient. Job Group M and above can attend any hospital they choose but however, there is a limit on how much the cover will pay i.e. sh 60,000 Dental, sh 50,000 Optical, sh 1,000,000 Inpatient and a similar amount for Outpatient.
Once any person using NHIF Cover goes to a Hospital they fill a Letter of Undertaking (LOU) to accept the offer. The Hospitals and NHIF have an agreement and the pay takes about 3 days to a maximum of 2 Weeks to get to the Hospital from NHIF.
As the officer advised residents to register for the Health insurance cover, a mother whose son (19 years) has been amputated one leg walked into the Kiambu Information office seeking assistance from a Good Samaritan to pay his hospital bill which has accumulated to over 300,000 as he continues to be detained at the Kijabe mission hospital.
Margaret Minitu Kugiri Showed KNA an NHIF card issued on- but cannot be of help to him as he applied for the card late. He was discharged from Kijabe hospital 3 weeks ago while the card was issued on 26th of April and the hospital contend that she cannot use the card now but on a later admission, he could use it.
She is therefore appealing to well-wishers to come to her aid and assist her pay the hospital bill so that he can be discharged from the hospital. She says she held an Harambee to offset the bill but only managed to raise 70,000 which she paid to reduce the amount that has since ballooned
Source: Kenya News Agency