NHIF Frequently Asked Questions

NHIF Frequently Asked Questions

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1)  Did you know that NHIF has partnered with private hospitals to offer value-added benefits to cater for additional expenses besides the daily rebate?
 2)  Did you know NHIF Members can access these services in most facilities including private hospitals like The Nairobi Hospital, Aga Khan, Mater, MP Shah, Gertrude's, Medanta, Vital ray etc.?
3)  Did You Know that NHIF covers the following specialized Radiology services?
  • CT Scan Kshs. 8,000/-
  • MRI Scans Kshs. 15,000/-
  • Dialysis Services Kshs.9,500/-
4)  Did you Know that the following classifications of Surgeries are covered under NHIF?
  • Minor Surgical Procedures between Kshs. 10,000 up to Kshs. 30,000
  • Intermediate Surgical Procedures between Kshs. 40,000 up to Kshs. 80,000
  • Major Surgical Procedures up to Kshs. 130,000
  • Specialized Surgical Procedures up to Kshs. 500,000
  • Kidney transplants up to Kshs. 500,000
  • Oncology Kshs. 25,000 to Kshs. 150,000 per cycle* up to a maximum 24 sessions p.a.

5)  Did you know you should Always carry your NHIF Card and ID card during your hospital visit?
6)  Did you know that you can visit any NHIF office or Huduma centre and update ALL your dependents (Spouses & Children ) on your NHIF card?
 7)  Did you know that the Hospital will seek NHIF pre-authorisation, hence you should ensure you fill a pre-auth form for all covered services?
8)  Did you know that as the patient you should seek pre-authorization if you require more than 2 Radiology sessions per week?
9)  Did you know that all Surgical Packages (must be preauthorized) by the facility via the NHIF hospital portal?
10) Did you know that for very special cases, the hospital may request the patient to seek NHIF pre-authorization direct?
In such cases, the documents required are:-
a.  Comprehensive medical report
b.  Filled NHIF Pre-auth form
c.  Pro-forma invoice
d.  scanned copy of NHIF card
e.  National ID

11) Did you know that FA medical cover caters for bills NET of any charges payable by another insurance/payer including NHIF?

Ensure you have your NHIF card and ID card for the procedures and the FA insurance cover will issue an undertaking for the difference.

* These rules DO NOT apply to life-threatening/emergency cases.  

You pay up to a Maximum 1,700/= a month and hence you should enjoy NHIF Services!!