NHIF Pays Out Kshs49 Billion in Healthcare Claims in 10 Months as Access to Quality Care Expands

by | Apr 24, 2023 | Health, News | 0 comments

The National Health Insurance Fund (NHIF) has affirmed its dedication to providing uninterrupted services to its members, in pursuit of Universal Health Coverage for all Kenyans. In a recent statement, the Fund highlighted that it has processed 4,596,407 claims since July 2022, amounting to KSh 49,026,094,635 ($49 billion) across over 8,000 hospitals both domestically and internationally.

NHIF’s mandate centers on collecting contributions and payments to secure essential healthcare benefits for its members. These contributions comprise monthly remittances from individuals, corporations as employers, and government support for employees and the needy. The Fund emphasized the importance of timely contributions and payments to ensure its sustainability and ability to pay eligible medical claims.

According to the statement, the NHIF has been actively supporting the government’s commitment to “leave no one behind” through flagship programs like Edu Afya, Linda Mama, and Health Insurance Subsidy Programs (HISP). Efforts to bring services closer to members include automation of claims processing, biometric registration, and identification for beneficiaries.

The NHIF has also been vigilant against medical fraud, which breaches ethical and legal standards and threatens the healthcare system and members’ well-being. The organization is strengthening its processes to penalize any member, healthcare provider, or staff member involved in fraudulent activities, as per the law.

In line with the NHIF Act 9 of 1998 amendments from January 10, 2022, new penalty rates for late monthly contributions will take effect on May 1, 2023. These penalties will apply exclusively to employers and private contributors, as stated in a circular by NHIF Acting CEO Samson Kuhora.


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