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About Us
 

National Hospital Insurance Fund is a State Parastatal that was established in 1966 as a department under the Ministry of Health. The original Act of Parliament that set up this Fund in 1966 has over the years been reviewed to accommodate the changing healthcare needs of the Kenyan population, employment and restructuring in the health sector.
Currently an NHIF Act No 9 of 1998 governs the Fund.

The transformation of NHIF from a department of the Ministry of Health to a state of corporation was aimed at improving effectiveness and efficiency. The Fund's core mandate is to provide medical insurance cover to all its members and their declared dependants (spouse and children). The NHIF membership is open to all Kenyans who have attained the age of 18 years and years and have a monthly income of more than Ksh 1000.

NHIF has 23 fully autonomous branches across the country. Each of these branches offers all NHIF services including payment of benefits to hospitals or members or employers. Smaller satellite offices and service points in district hospitals also serve these branches.

Benefits
  • NHIF provides an inpatient cover of up to Ksh 396,000 per year for the contributor, spouse and children.
  • NHIF provides comprehensive medical cover in certain hospitals across the country.
  • NHIF works with a wide network of over 400 accredited Government, private and mission health providers spread across the country.
  • The Fund reimburses hospital claims as per agreed daily rebates.
  • Covers maternity cases.
  • NHIF does not exclude any disease.
Accrediting and Contracting Hospitals
  • The Fund strives to accredit as many hospitals as possible so as to ensure all members access NHIF benefits whenever they are across the country.
  • NHIF has an objective accreditation criteria and guidelines that aim to encourage hospitals towards quality improvement.
  • Accredited organizations are those recognized by the Fund and allowed to offer services to NHIF members and claim reimbursements thereof.
  • Accreditation of a health provider takes into account the services, personnel, infrastructure and equipments among other issues that the institutions have. The level of rebate therefore corresponds to the grade after scoring the various aspects.
  • The Fund, further contracts the health facilities to ensure they provide services comprehensively. This means that NHIF members walk in and walk out of the facilities fully treated at the cost of NHIF without making additional payments.
  • The contracts spell out the obligations of the health provider and NHIF.

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