NHIF to give an unlimited cover to Chronic Disease Patients

NHIF patients with chronic diseases such as hypertension, diabetes, cancer, arthritis, heart failure, and kidney failure are set to receive unlimited medical coverage from the National Health Insurance Fund. This news comes after the government revised contribution rules and proposed a 2.75 percent pay cut for all employees across the country.

The new proposals also remove the limits on the extent of coverage previously imposed on NHIF contributors with chronic diseases. This means that patients with chronic illnesses will receive unlimited payments for their treatments such as chemotherapy, radiotherapy, and dialysis for kidney failure patients as long as their premiums are up to date.

Previously, chronic disease patients were paying for their treatments out of pocket once they exhaust their limits.  With the high cost of services like chemotherapy and radiotherapy, almost all chronic disease patients ended up paying out of pocket for their services while at the same time paying premiums to NHIF, an NHIF nightmare

The following are some of the services that will be covered exclusively by NHIF for chronic disease patients:

Dialysis healthcare services covered by NHIF

The cost of Registration, triaging, Consultation, and Specialist reviews

Cost of the temporary catheter, plus catheter insertion and removal.

Cost of Nursing and dialysis services, and routine laboratory tests.

The cost of maintenance drugs, counseling, and follow-up.

Cancer Diagnosis and Treatment Services covered by NHIF

Under Cancer treatment services, NHIF will the cost of:

Chemotherapy, Radiotherapy, Brachytherapy, Consumables, medications, Routine laboratory tests, Blood transfusions, PET-CT scans, Radioiodine therapy, Bone scan, and radio nucleoid scans.

NHIF covers 2 dialysis sessions per week within the cover limits; which are to be removed under the new regulations kicking off in the next few months. It also pays for renal transplants for up to half a million shillings. Whether this is also going to be increased is not covered in the draft of the new regulations. 

The new regulations rely on the success of the new changes in premium contributions that will see those who earn more than Ksh 35,000 contribute a larger fraction of their salaries to NHIF than usual.

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1 Response

  1. January 12, 2024

    […] Chronic Diseases are also covered by NHIF although the coverage is not clear as there is no special package for hypertensive or diabetic […]

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