How to register for NHIF

The National Hospital Insurance Fund (NHIF) is a Kenya government state corporation with a mandate to provide health insurance to Kenyans. The core business and mandate for NHIF is to provide accessible, affordable, sustainable and quality health insurance for all Kenyan citizens. NHIF registers all eligible members from both the formal and informal sector. For those in the formal sector, it is compulsory to be a member. For those in the informal sector and retirees, membership is open and voluntary.

Benefits of being an NHIF member

NHIF members enjoy the following benefits.

1. Upon admission in hospital an NHIF member is accorded services and the hospital makes a claim to the Fund for reimbursement.
2. An in-patient cover for the contributor, declared spouse and children.
3. Provides comprehensive medical cover in majority of accredited Government facilities, Mission health providers and some private health providers across the country.
4. Provides in-patient services in private and high cost hospitals on a co-payment basis.
5. Comprehensive maternity and CS (Caesarian) package in government hospitals, majority of mission and some private hospitals.
6. Dialysis.
7. Family planning (Vasectomy and Tubal Ligation).
8. NHIF does not exclude any disease.

Contributions and deductions

Formal sector employees’ contributions are deducted and remitted to the Fund by their employers. This is done by Cheque or through E-banking. For members under the voluntary category, they pay Ksh 500 per month (Ksh 6,000 per annum). For those in formal employment, contributions are made as per their income.

The following premium rates apply:

Payment of claims

Claims are submitted by hospitals directly to NHIF after the contributors have been discharged from the hospitals. The claims are examined by the Fund to ensure validity before payment. A claim can however be rejected and the hospital informed accordingly to incorporate either the missing documents or to address the abnormalities identified. The Fund strives to pay claims within 14 days upon receipt of the claim from the hospitals. Members who opt to clear the bills with the hospital may launch a general claim directly to NHIF for reimbursement.

Sponsored programmes

NHIF seeks to establish partnership with individuals and organizations to finance health insurance for indigents including orphans and vulnerable children, poor older persons, persons with disabilities and destitute families. The indigents shall be identified by NHIF or the sponsors. Enrolled indigents and their dependants shall have access to the current benefit package of inpatient cover in any of the health providers accredited to NHIF countrywide.

Services covered by NHIF

Here are the services covered by NHIF.

1. Inpatient services health cover.
2. Outpatient services health cover.
3. Civil Servants schemes health cover.
4. Linda Mama services health cover.
5. NHIF Supa/Super cover.

Accrediting and contracting hospitals

The Fund strives to accredit as many hospitals as possible so as to ensure all members access NHIF benefits whenever they are across the country. NHIF has an objective accreditation criteria and guidelines that aim to encourage hospitals towards quality improvement. Accredited organizations are those recognized by the Fund and allowed to offer services to NHIF members and claim reimbursements thereof. The contracts spell out the obligations of the health provider and NHIF.

Accreditation of a health provider takes into account the services, personnel, infrastructure and equipments among other issues that the institutions have. The level of rebate therefore corresponds to the grade after scoring the various aspects. The Fund, further contracts the health facilities to ensure they provide services comprehensively. This means that NHIF members walk in and walk out of the facilities fully treated at the cost of NHIF without making additional payments. 

Members requirements

To register for NHIF as a member, you must meet the following requirements.

1. A resident of Kenya, who has attained the age of 18 years. (No age limit after the age of 18 years).
2. Total income from salaried or self-employment is more than Ksh 1,000 per month or Ksh 12,000 per year.
3. Drawing an income from Kenya.
4. Working under contract or casual terms of employment.
5. A voluntary contributor. This includes foreign visitors permitted to work or study in Kenya.
6. Kenyan residents must have:
   • Copy of National I.D (including spouse if applicable).
   • Copy of Employer Appointment/Introduction Letter (excludes self-employed/voluntary contributors).
   • Coloured passport photo (including spouse & dependants if applicable).
   • Original & copies of birth certificate(s) for dependants.
7. Foreign residents must have:
   • Copies of passport, alien certificate or work permit (including spouse if applicable).
   • Coloured passport photo (including spouse and dependants if applicable).
8. Foreign students must have:
   • Copy of passport.
   • Coloured passport photo.
   • Submit the required amount under the Voluntary/Self Employed Category.

Employers requirements

To register for NHIF as an employer or organized group, you must meet the following requirements.

1. Certificate of Registration
2. KRA PIN Certificate

How to register for NHIF as an employer

To register as an employer or organized group, fill in the Employers Form and drop it off at any of NHIF branches located countrywide. Alternatively, you can register online by filling in the required details on the online form and uploading the scanned copies of documents you will be asked for.

How to register for NHIF as a member

To register with NHIF as a member, fill in the Members Form and drop it off at any of NHIF branches located countrywide. Alternatively, you can register online by filling in the required details on the online form and uploading the scanned copies of documents you will be asked for.