National Hospital Insurance Fund (NHIF) Supacover Medical Plan

The National Hospital Insurance Fund (NHIF) is a government-run medical insurance service. With the eventual goal of offering universal healthcare for all Kenyans. Not to mention, everyone in Kenya requires to be a member of the fund in order to enjoy all its benefits. Including but not limited to its old but newly revamped complimentary Supa Cover package.

Furthermore, the NHIF Fund is the main source of medical insurance for civil servants and it’s quite important to be a paid-up member of NHIF. Simply, because of the benefits, this membership affords you as a person. That said, you can read and learn more about the benefits of using the National Hospital Insurance Fund (NHIF) in detail before you can move on.

But, before we get into the registration process, allow me to tell you what NHIF actually means. By definition, NHIF stands for the National Hospital Insurance Fund. And it’s a Kenya Government Parastatal established back in the year 1966. Eventually, it offers medical cover to Kenyan citizens at a small premium, especially, through the NHIF payment scheme.

Bearing this in mind, the government of Kenya — under the Ministry of Health plus other key medical partners — was interested in improving the overall health care for all its citizens. So, what does medical insurance coverage really entail?

What A Medical Insurance Cover Is All About

Generally, a Health Insurance Plan or Medical Insurance Cover — such as The National Hospital Insurance Fund (NHIF) —  is insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over numerous persons. Particularly, by estimating the overall risk of health care and health system expenses over the risk pool.

Everyone in Kenya requires to be a member of the fund. The fund is the main source of medical insurance for civil servants. It is quite important to be a paid-up member of NHIF. In the end, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement.

The benefit is administered by a central organization such as a government, agencyprivate business, not-for-profit entity, and many other medical institutions. According to the Health Insurance Association of America, health insurance is defined as “coverage that provides for the payments of benefits as a result of sickness or injury.

It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment.” With that in mind, make sure that you read and learn more about what Medical Insurance and Health Cover are all about in detail. Moving on, there are many benefits that The National Hospital Insurance Fund (NHIF) offers to its customers…

The Overall National Hospital Insurance Fund Benefits

First of all, the National Hospital Insurance Fund (NHIF) is the primary provider of health insurance in Kenya. Technically, with a mandate to enable all Kenyans to access quality and affordable health services. Thus, for this reason, NHIF is positioning itself as a key player in the attainment of universal healthcare in the country.

Secondly, the National Hospital Insurance Fund is an assurance that your medical bill will be covered should you or the dependant falls sick. When a relative is sick, it is a trying moment and the stress from finances is the last thing you want to hear; NHIF payment is the safest solace. Besides, it covers a wide spectrum of medical events that can happen to anyone, at any time.

It is proposed that the benefits package bears both curative and preventive elements. As well as to include both outpatient and inpatient medical-related services and solutions.

Comprising of: –
  • General consultation
  • Laboratory checkups
  • Drugs administration
  • Medicine dispensation
  • Dental healthcare services
  • Radiological examinations
  • Nursing and midwifery services
  • Surgical and transplant services
  • Radiotherapy and physiotherapy

These services shall translate to the following benefits under the prescribed level of the facility:-

  1. Medical consultation with a Doctor, Clinical Officer, or Nurse
  2. Specialist care in hospitals and similar institutions for in-patient and out-patient (ambulatory) care;
  3. Drugs and essential medical supplies;
  4. Hospitalization ( in-patient care) when needed;
  5. Dental care as well as referral where necessary, among others…

But, there are so many benefits to enjoy! Suffice it to say, any other notable benefits may be reviewed and approved by the NHIF Board first. Tertiary care such as specialized surgery, chronic disease management intensive care, and cancer therapy may be covered once a program for the same is put in place. Below are a few key reasons that make NHIF unique:

It Offers Per Net Cost Health Insurance 

When you buy a commercial medical insurance policy from a local healthcare provider such as Jubilee insurance, Britam, resolution insurance, or any other medical insurance company in Kenya. Your insurance calculates the net of the NHIF contribution to your hospitalization.

Since membership in NHIF is mandatory for employed persons. Thus, health insurance companies assume that everyone who buys additional insurance from them is actually buying Additional Insurance. The policy benefits, therefore, calculates as net of the amount NHIF should pay.

It Subsidizes The Hospitalization Cost 

The second reason why everyone should consider NHIF membership is that it subsidizes the cost of treatment. In recent times, NHIF has been expanding its scope of coverage. Until recently, NHIF has been refunding providers only when a member is hospitalized.

However, in recent times, the fund has been working towards refunding even costs associated with outpatient services. A recent media report indicates that NHIF will start paying for costs associated with the treatment of cancer, and the cost of dialysis. This is a welcome move given that most people in Kenya do not have robust privately funded medical insurance coverage.

Its Plan Is Relatively Cheap To Pay

Finally, the cost of NHIF members is relatively cheap. Hence, the benefits are competitive, especially in the case of hospitalization. One of the key advantages of the NHIF is that one pays medical insurance costs monthly rather than annually. Thus, making it affordable. Also, the rates are affordable even for low-wage workers. NHIF members contribute Kshs 500 per month.

These costs are lower than for any other cover. For instance, Linda Jamii requires members to pay 12,000 per annum, meaning that the monthly charge is Ksh 1000. Having an active membership with the NHIF is a smart decision for every discerning Kenyan.

The National Hospital Insurance Fund (NHIF) Supacover Package

Basically, the National Hospital Insurance Fund is a pool managed by the government where citizen makes monthly NHIF payments or contributions. This money is safeguarded such that when an unprecedented event happens to members money is released. In that case, to help them manage the situation and bounce back to normalcy.

This pool has managed to pull together Kenyan from all walks of life and status, hence managing the fund in terms of disbursement and receiving money is safe from collapsing. Besides, the government is the overall watchdog. So, what does The National Hospital Insurance Fund (NHIF) Supa Medical Cover Package really entail?

Or rather, do you know if you are on the National Scheme or the Supacover? Well, as I aforementioned, the Supacover Package is actually their older product — which they have just revamped recently — to include 1o additional benefits. So that they can give you better quality services. This means, that you don’t need any additional requirements or processes to enjoy it.

It mainly covers:
  • Maternal care services
  • Inpatient medical services
  • Outpatient medical services
  • Reproductive health solutions
  • Scanning and radiology imaging
  • Cancer-related disease treatment
  • Emergency (road accident) evacuation
  • Laboratory checkup/screening services
  • Outside country/overseas treatment
  • All surgeries including transplants
  • Drug and substance abuse rehabilitation
  • Renal dialysis, and much more…

Of course, these are just but a few among many other coverages that a single NHIF medical cover policy has in place. And, of interest is that all these services are offered to all members regardless of age according to the 2019-2020 review. This was not there conventionally; age mattered when giving these policies and often paid higher rates.

Realistically, there are certain operative measures put in place to ensure the fund benefits all without misuse. For instance, the fund limits the number of hospital visits one can make in a year and still have their bill covered. Other than these the state parastatals check eligibility for cover; not all members can be covered by the scheme. There’s a hard nut there, let me expound…

NHIF Services:

If a member, for example, is not consistent in making NHIF payments, or for some time has stopped such is not eligible to cover. Additional reasons for not being eligible are misrepresentation, false identity, and faulty details. The administration of cover is one of the reasons NHIF services are in high demand and popular.

This is because they do not only give medical cover to individuals alone but also cover dependents or family members. For instance, a man may have a cover that would meet the medical bills of the wife and children so long as the system knows them as dependents.

Scheme Benefits:

The only surety to benefit from this scheme is to frequently check the NHIF account status online. With this in mind, allow me to briefly highlight the ethics under which NHIF operates. So to say, before I even teach you the trade of how to check NHIF account status online.

The National Hospital Insurance Fund has a visionary aim to be a world-class social health insurer. This is going to be achieved if they follow the path – mission. By all means, which is to provide quality, accessible, affordable, sustainable, and equitable social health insurance to all stakeholders. Who are members through efficient resource use?

Guiding values:

Since its enactment, NHIF has been at the forefront of championing and lobbying for support in order to offer quality health services to the people. Without having to clash with the needs of the people and the administration of NHIF.

Honesty – all NHIF staff should be honest in all their endeavors as they execute their duties which should be done in good faith with the interest of the people at heart.

Integrity– this is all about upholding due diligence; hardworking trustworthiness. Integrity can be divided into two; corporate and individual integrity, how so the two should be practiced in all operations of NHIF and the advancement of its services.

Accountability – the parastatal is accountable to the public for any action they do, any activity they engage in, and any form of decision that is made.

Professionalism – on the basis of personality integrity; staff members and other stakeholders should be objective, competent, impartial, and work ethically for the growth of themselves corporately and individually with no ill intent.

Commitment – there should be a dedication to pull together that is inherent and not coerced so that it is productive. All energies should be channeled toward the services provided for optimal resource utilization. This is a replica that cements public confidence.

Checking the National Hospital Insurance Fund accounts

In the recent past, mainstream media has been reporting about the various changes and reviews that are taking place within the National Hospital Insurance Fund. This is in an attempt to improve health care and even diversify and increase the scope of coverage.

Regrettably so, the NHIF Payment options have been stretched out and members have to dig a little deep into their pockets. Approaching it from a sober angle how then can the broad scope of health services be covered if not in the periodic premiums? Well, this just explains the skyrocketing cost of health care in Kenya today.

Read Also: List of NHIF accredited hospitals in Kenya

One of the primary changes that the National Hospital Insurance Fund has experienced is the upgrade of the system. Thanks to technology, service delivery has become more efficient, quick, and instant.

System automation is probably one of the best inventions in the world of technology; there is no need to walk into your nearest NHIF branch to have your account details checked. From the comfort of your home or location, one can seamlessly get their NHIF Account status online.

There are three ways how to check NHIF account status. One is the conventional walking into the branch and having the attendant go through your account and give you the details. The other two ways are what I would like to outline how to go about this.

How do I check the NHIF account status online?

The Internet is a vital tool for the success of modern-day businesses. Similarly, the National Hospital Insurance Fund had embraced the use of technology. From whence information about its services and operations, terms, and conditions can be found. Here is the step-by-step analysis of how to check NHIF account status online:

Step One:

With your internet-enabled device, get to the NHIF official website: There is a self-service portal for you to sign up to gain access.

If you are visiting the site for the very first time, you need to first register in order to receive the services. There are three paramount requirements; the NHIF card numbers, a valid email address, and a day working phone number. In case they would like to reach up to you for inquiries or other reasons.

Step Two:

This follows several prompts to fill up other personal details which should be duly filled in before saving or submitting.

Develop a password that you will use every time you log onto the portal, this should be easy to remember yet not so obvious. However, it can be reset in case you have completely forgotten your password for the NHIF account status online inquiry.

Step Three:

Technically, this is how to create an NHIF self-service individual account.

Now, log onto the NHIF self-service portal and proceed to get your NHIF account status online. Information about how you make the monthly NHIF payment, balance, anytime one has defaulted, and activation period among other details.

For the security of your bio, log out from the device after you are done checking the NHIF account status online in Kenya.

How do I check the NHIF account status on mobile? 

Mobile phones are one of the electronic devices that have a central position in the life of human beings.

Be it communication, payment of utility bills, checking utility bills online, or online interaction among other things the phone does all that work seamlessly.  Above all, which makes mobile phone services affordable, popular, convenient, and sustainable.

This is just what the market was hungry for or deprived of before technology brought relief. One of the many services a mobile phone is able to do which is my focus for today is how to check the NHIF account status online via a mobile electronic device. It is an accurate and almost impromptu service so long as all the details are entered right.

Additionally, it’s very easy to have your NHIF account contribution status via your phone.

Here is how to go about it; 

Go to the main menu on your mobile phone and select the message icon by touching it if using an android phone or just click on the icon for QWERTY phones.

This opens the message thread for inbox, at the top there is a composing prompt, click on it. At the message space, type ID, a space followed by the ID number or the Passport number if applicable. For example, ID 123456 was sent to the NHIF number which receives and processes details for you.

This message should be sent to 21101 which is the NHIF recipient. And this is the easiest way to check the NHIF account status.

The use of a mobile phone in checking NHIF account status is highly reliable and will give you results just as if you had logged online on your self-service portal. You, therefore, need not shy away from using it. However, a service charge of Kshs. 10 applies.

Checking the National Hospital Insurance Fund statement 

With the increased sensitization of the need to have an NHIF membership and the benefits thereof, people have become more cautious of their accounts. More often they want to check if it complies with the terms. So that there is no late repayment that attracts penalties among other things that may affect you from getting needed when the time is here.

The question of how I see my NHIF statement online is therefore valid. But, after you have logged into your individual account as I had outlined in How to check NHIF account status online above.

Head directly to the payment options there you will be able to make your payment. After which all the reports and mini-statements about your monthly payment history can be obtained. It is as easy as that!

What are the National Hospital Insurance Fund penalties?

As stated earlier, the National Hospital Insurance Fund operates under laid down guidelines, terms, and conditions.

Ensuring that it does not collapse and the members get the needed relief in times of need without much hassle. The chief eligibility consideration is the NHIF payment history.

So, the more timely and consistent you make the NHIF payments the faster you are. If a certain occurrence that requires this medical cover happens then the cover will bail you out. Inconsistency will render your problems.

However, NHIF acknowledges that one may fail to pay the monthly contributions. For reasons beyond their control yet they desperately the fund.

Formal & Informal Penalties

The National Hospital Insurance Fund penalties for late payments in Kenya then apply. Of course, the NHIF penalties for late payment in Kenya apply in two varied ways;

Firstly, for those in the formal and informal sectors, penalty treatment is served separately. If you are in formal employment and fail to pay timely, then the penalty you attract equals the amount you are supposed to contribute. This implies you will pay double the amount.

If in informal employment, a 50% charge will have been attracted following late payment. So, if you contribute Kshs. 500 monthly to the NHIF, the late payment means you will pay Kshs. 750. All monthly contributions should be made on or before the 9th of every month.

Furthermore, the NHIF payment made after this date is considered late payment and attracts penalties.

How do I make my NHIF monthly contribution? 

There is various NHIF payment option but the underlying factor is that money gets to the same pool which is the National Hospital Insurance Fund. First, one can access the pay online portal and make the payments. This is one of the fastest payment modes.

Secondly, a bank standing order can be executed to have funds channeled from the personal account to the NHIF account monthly. And on command without failure so long as the account has some money. This is when the employer does not pay the contributions although ordinarily it is deducted directly from the payslip by the employer.

It is common among those in formal employment whose compensation comes through the banks. They execute a standing order to relieve them from late payment or even forgetting to make the payment. However, if you are in the informal sector but have a stable bank account this method can also work for you – NHIF payment.

Summing Up,

Finally, NHIF payment can be made through the use of a mobile money transfer service – M-Pesa.

Whereby, money is loaded to the individual Safaricom mobile phone number, and then transferred to the National Hospital Insurance Fund. Through the NHIF M-Pesa pay bill number 200222.

Here is the procedure: 
  1. Go to the M-Pesa menu and select the pay bill option
  2. Then enter the NHIF M-Pesa pay bill number, 200222
  3. Enter your ID Card number in the subsequent lead
  4. Key in the amount – NHIF payment monthly contribution
  5. Enter the M-Pesa pin and send

With a confirmation message being sent. As well as the acknowledgment message of the money received.

Related Resources:

  1. What is a Health Insurance Cover?
  2. Urine Color » What It Indicates About Health
  3. WIBA (Work Injury Benefits Act) Overview
  4. Physical Fitness on Beginners Weight Training
  5. Fruits Benefit To Our General Health
  6. Licensed Insurers List – Insurance Regulatory Authority

That’s it! Everything to know about what The National Hospital Insurance Fund (NHIF) Supacover Medical Plan is plus what the package entails. It’s my hope that the above-revised guide on the benefits of using the National Hospital Insurance Fund was useful. But, if you’ll have additional questions, recommendations, or even suggestions, please Consult Us for more help.

Or even, feel free to share your additional insights, suggestions, opinions, or even general contribution questions (for FAQ Answers) in our comments section below this post.

Not forgetting, we’ve got other more Adequate and Credible Lifestyle Blogs that are for general public information and reference purposes, for free!

Including, the IndependentInsureAfrikaResolution InsuranceCapital News, jmexclusives (general health & fitness research blog), etc.

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