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 members of the fund.
After all, 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. Learn more about the benefits of using the National Hospital Insurance Fund (NHIF).
But, before we get into the registration process, allow me to tell you what NHIF means. Whereby, 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. And especially, through the NHIF payment as the government was interested in improving health care.
What is a Medical Insurance Cover?
Generally, a Health Insurance Plan or Medical Insurance Cover is an insurance that covers the whole or a part of the risk of a person incurring medical expenses, spreading the risk over numerous persons. By estimating the overall risk of health care and health system expenses over the risk pool.
Everyone in Kenya requires to be members 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, agency, private business, or not-for-profit entity.
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.” Learn more about Medical Insurance and Health Cover.
Why the National Hospital Insurance Fund?
The National Hospital Insurance Fund is an assurance that your medical bill will be covered should you ar 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. Such as;
- Inpatient & outpatient services,
- maternal care,
- reproductive health services,
- surgical procedures,
- emergency road evacuation services,
- renal dialysis, and
- cancer treatment among much other coverage a single NHIF policy has.
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.
Here are more benefits!
Health insurance is issued net of NHIF costs
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 companies 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.
Subsidizes the cost of hospitalization
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 covers.
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 the medical insurance costs monthly rather than annually. Thus, making it affordable. Also, the rates are affordable even for low wage workers. NHIF members contribute from 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.
How does the National Hospital Insurance Fund work?
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 member 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 of 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. However, 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 of cover; not all members can be covered by the scheme. Allow me to expound because I have paused a hard nut there.
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. 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 dependants.
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 under. 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.
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 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 trustworthy. 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 towards the services provided for optimal resource utilization. This is a replica that cements the 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 on how to check NHIF account status. One is the conventional walking into the branch and has 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 them.
How do I check the NHIF account status online?
The Internet is a vital tool in 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:
With your internet-enabled device, get to the NHIF official website: www.nhif.or.ke. 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.
This follows several prompts to fill up other personal details which should be duly filled 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.
Technically, this is how to create an NHIF self-service individual account.
Now, log onto the NHIF self-service portal and proceed on to get your NHIF account status online. Information about how you make the monthly NHIF payment, balance, anytime one has defaulted, 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 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 life if human beings.
Be it communication, payment of utility bills, checking utility bills online, 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 the relief. One of the many services a mobile phone is able to do which is my focus for today is how to check 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 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 compose 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 sent to the NHIF number which receives and processed details for you.
This message should be sent to 21101 which is 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 the 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 need when time is here.
The question of how do 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. It a certain occurrence that requires this medical cover happens then the cover will bail you out. Inconsistency will render you into 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 Kenya apply in two varied ways;
Firstly, for those in the formal and informal sectors, penalty treatment is served separately. If you are in the 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 www.nhif.or.ke 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 the 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.
Finally, NHIF payment can be made through the use of 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:
- Go to M-Pesa menu and select the pay bill option
- Then enter the NHIF M-Pesa pay bill number, 200222
- Enter your ID Card number in the subsequent lead
- Key in the amount – NHIF payment monthly contribution
- Enter the M-Pesa pin and send
With a confirmation message being sent. As well as the acknowledgment message of the money received.
I hope 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 Contact Us. Or even, feel free to share your insights in the comments box below this post.
Finally, there are more Adequate and Credible Sources that are for general public information and reference purposes only.
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