Health Cabinet Secretary Susan Nakhumicha has released a fresh publication detailing the treatment fees slated for employment within the Social Health Insurance Fund (SHIF). According to the document, individuals covered by SHIF insurance will have access to six complimentary services at SHIF-certified hospitals across Kenya.
Kenyans will have access to a range of services, including Antiretroviral (ARV) treatment, HIV testing and follow-up tests, family planning, antimalarial medication and testing. Additionally, free services will extend to anti-tuberculosis treatment and immunisation services for children.
The guidelines state, “ARVs, antimalarials, anti-TBs, and related tests, family planning supplies, and KEPI vaccines will be available at public facilities, as well as faith-based and private facilities that report to the health information system.”
On the other hand, the Ministry also released guidelines and tariffs for common services such as outpatient and inpatient.
The tariff for outpatient services has been set at Ksh2,000 per visit, with a cap of four visits per individual annually.
Outpatient services encompass consultation, diagnosis, and treatment, as well as prescribed laboratory tests and basic radiological examinations such as X-rays and ultrasounds, alongside prescription, drug administration, and dispensing.
Meanwhile, in-patient services at Level 4-6 facilities will incur varying charges based on the facility’s classification. For example, at Level 4 facilities, in-patient services will be billed at Ksh3,500, whereas Level 5 facilities will charge Ksh4,000.
At Level 6 health facilities, the proposed inpatient tariff stands at Ksh5,000.
The range of inpatient services encompasses hospital accommodation fees, meals, and nursing care within a general ward bed.
The report states, “Inpatient services will cover the management of diseases/conditions during admission, including intra-admission consultations and reviews by both general and specialist consultants, laboratory tests, medical imaging, procedures, and medications.”
Normal delivery and essential newborn care are priced at Ksh11,200, while caesarean section and essential newborn care are set at Ksh32,600.
“SHIF maternity services will be accessible to members and their dependents with active membership. In case of peripartum and postnatal complications extending beyond 48 hours for normal deliveries and 72 hours for caesarean section deliveries, a per diem rate will be applied. All claims in this category will undergo surveillance,” the Ministry proposed.
For mortuary preservation, coverage will be limited to 5 days at a rate of Ksh500 per day.
The public is invited to provide feedback on the proposed charges and submit their suggestions before June 17.
“The comments, opinions, representations, and any written memoranda can be sent to the Office of the Cabinet Secretary in Nairobi; delivered in person to Afya House, 7th Floor, Nairobi; or emailed to regulations@health.go.ke; to be received by June 17, 2024, at 5:00 pm.
“Furthermore, there will be physical and virtual meetings for public consultations and stakeholder engagement regarding the draft Tariffs. The Ministry and Social Health Authority will communicate the dates and venues for these physical and virtual public participation events,” advised the Cabinet Secretary.
Deductions
Salaried Kenyans are expected to commence payment of 2.75 per cent of their salaries to the Social Health Authority (SHA). Those with an income will pay the same rate.
Unemployed Kenyans will pay a minimum rate of Ksh300.
