NHIF EduAfya is a unique comprehensive medical insurance cover for public secondary school students during the duration of study. EduAfya can only be utilized by primary policy holders; in this case, the student and is not transferable or cannot extend to any other dependent.
Benefits of EduAfya package
The EduAfya program comes with the following impressive benefits.
1. Outpatient
This caters for all routine outpatient services as per Kenya essential package for health subject to policy terms and conditions. It includes the following:
- General Out-patient Services: Outpatient services provided by or on the order of a clinician/physician who is licensed as a general practitioner.
- Specialized Out-patient Services: Outpatient services provided by or on the order of a physician who is licensed as a specialist or consultant and to whom a member has been referred to by a general practitioner/primary care clinician where a member was registered.
- Referral for specialized services which includes the following:
- Drug and Substance Abuse Rehabilitation Services.
- Renal services and dialysis.
- Specialized radiological diagnostic services.
- Chronic ailment services such Diabetes and Hypertension, Ultrasound, ECG.
- Cancer medical care and treatment services which includes radiotherapy services, chemotherapy services or surgical intervention subject to preauthorization by NHIF.
2. Inpatient
Inpatient shall be on a referral basis from the selected outpatient Health Care Provider. This cover includes medical and surgical conditions which require admission. It includes the following:
- Hospital accommodation charges.
- Pre-hospitalization diagnostic services.
- Doctor’s (physician, surgeon & anesthetist) fees.
- Nursing charges.
- Drugs/medicines, dressings and internal surgical appliances.
- Diagnostic, laboratory or other medically necessary services.
- Rehabilitation services.
- Operating theater services.
- Radiological diagnostic e.g., x-ray services, CT scan, MRI, ECG.
- In-patient physiotherapy.
- Day care surgery surgical procedures that do not require overnight stay.
3. Dental cover
Dental benefit caters for outpatient dental procedures, which include but not limited to:
- Extraction.
- Root canal.
- Dental X-ray Services.
- Accident related inpatient dental cases will be covered under the standard inpatient surgical benefits to the full inpatient limit.
4. Optical cover
An optional benefit that caters for expenses related to eye treatment, including the cost of:
- Consultation.
- Eye testing.
- Prescription for ophthalmic treatment and prescription of eyeglasses.
- Accident related inpatient optical cases will be covered under the standard inpatient benefits to the full inpatient limit.
5. Emergency Road Rescue
Ambulance services for transportation and transfer of a sick member for treatment from a place of incident or facilities where adequate care is not available to the next available NHIF accredited hospital or medical facility within the territorial limits of Kenya.
6. Emergency Air Rescue
Emergency Air Rescue services will be provided for transportation and transfer of an injured member to an NHIF accredited facility within the territorial limits of Kenya where adequate medical care is available.
7. Overseas treatment
Treatment costs arising from a condition that warrants treatment overseas because the treatment is not available in Kenya will be covered subject to preauthorization from NHIF.
8. Group life
Group personal accident cover and last expense.
EduAfya registration requirements
Here are the requirements you must meet before signing up for the EduAfya cover.
- Must be a student in a public secondary school.
- Must be registered under the National Education Information System (NEMIS) database.
- Must be registered by NHIF.
How to register for NHIF EduAfya package
Students in public secondary schools can access a comprehensive medical cover from NHIF’s EduAfya product partly made possible by the NEMIS database.
- Be a student registered on NEMIS for public school students then the data is shared by Ministry of Health to NHIF.
- Biometric registration will be done physically by NHIF at the respective schools.
