List Of NHIF Benefits

This is a list of all benefits offered by the National Hospital Insurance Fund ( NHIF). As highlighted earlier on this site, NHIF is government state corporation which provides health insurance to Kenyans over the age of 18 with a monthly income of Ksh 1,000 and above. Since its launch in 1966, NHIF has been able to accommodate the changing health care needs of the Kenyan population, employment and restructuring in the health sector.

NHIF registers all eligible members from both the formal and informal sector. For those in the formal sector, it is compulsory to be a member. For those in the informal sector and retirees, membership is open and voluntary. To register with NHIF as a member, follow this simple guide.

NHIF Benefits Package 

The NHIF Benefits package is the total of health services that a member is entitled to for the premium paid to the Fund.

Components of The NHIF Benefits Package 

1.Consultation

The general outpatient consultation is provided for by the staff below

  • Medical Officer
  • Dental Officer
  • Nurse/Midwife
  • Clinical Officer
  • Community Oral Health Officer

2.Laboratory investigations

  • Haematology (Hb, RBC/WBC counts, hematocrit, peripheral film)
  • Differential white cell count
  • Peripheral Blood Film
  • Sickle Cell Test v. ABO & Rh Grouping
  • Syphilis Screening
  • Gram Stain
  • Ziel Nielsen Stain
  • Potassium Hydroxide Preps
  • Wet preparation
  • Urinalysis
  • HIV Test
  • Pregnancy Test
  • Widal Test
  • Stool for o/c
  • Blood Slide/ thick film for Malaria Parasite
  • Cervical Smears –cytology
  • Urine Microscopy (deposit)
  • Blood Glucose
  • Blood Transfusion Collection, Screening and Storage Compatibility Test and Blood Unit
  • Bleeding and coagulation time
  • Parasitological (RDT)

3. Drugs administration and dispensing

This is provided as per the needed care during the visit inpatient or outpatient visit as per the accreditation status of the facility.

4.Dental Healthcare Services

  •  Tooth Extraction

5.Radiological Examinations

  • Hand and Finger – AP/LAT
  • Wrist Joint – AP/LAT
  • Forearm – AP/LAT
  • Chest – PA
  • Chest – PA & LAT
  • Clavicle – PA/AXIAL
  • Scapula – AP/LAT
  • Sterno-Clavicular
  • Foot and Toes – AP/LAT
  • Ankle Joint – AP/LAT
  • Leg – AP/LAT
  • Knee Joint – AP/LAT
  • Skull – AP/LAT
  • Plain Abdominal x-ray
  • Facial Bones – A.P.&LAT

6. Nursing and Midwifery Services

  • Regular Nursing Care
  • Drugs and Vaccines Administration
  • Observations of vital signs
  • Temperature
  • Pulse
  • Respirations
  • Blood Pressure
  • Personal Hygiene Care – Bed bath
  • Skin Care
  • Treatment of pressure areas
  • Tepid Sponging

Specimen Collection

  • Blood
  • Sputum
  • Swabs (Pus, throat, etc)
  • Stool
  • Urine
  • Pap Smear

-Oxygen Administration and care per hr.

-Disinfection and Sterilization(pack)

-Suction

-Intravenous infusion care

  • Ear Syringing
  • Giving Enema
  • Giving suppository
  • Last offices
  • Eye swabbing/irrigation
  • Tube feeding
  • Surgical Dressing
  • Small wound
  • Medium wound
  • Catheterization and Removal of Urinary Catheter
  • Washout/lavage
  • Stomach
  • Suturing
  • Small wound
  • Medium wound
  • Removal of suturing
  • Vulval toilet

MIDWIFERY PROCEDURES

  • Labour monitoring including parto-graphing and Normal delivery and Caesarean Section
  • Incision and Drainage of Cyst/Absess
  • Manual Vacum Aspiration (MVA)
  • Pap Smear
  • Ultrasound – (General)

FAMILY PLANNING PROCEDURES

  • Counselling clients for Family Planning
  • Natural Family Planning Education and training
  • Contraceptives

7. Surgical Services

  • General Surgery

Minor Surgery

  • Incision and Drainage
  • Circumcision (except for therapeutic and not cultural indications)
  • Excision of lipoma
  • Excision of Ganglion
  • Excision of Sabaceous Cyst
  • Incision and Drainage
  • Excision of lipoma
  • Lymph Node Biopsy

Orthopaedic Surgery

  • Minor Surgery
  • Joint Aspiration
  • POP Applications

Neurosurgery

  • A suture of scalp wounds (GA&LA)

Paediatric Surgery

  • A release of Tongue Tie

8.  Radiotherapy

9.Physiotherapy Services

  • Exercise therapy( per session)
  • general exercise
  • pre & post natal
  • pre & post-operative
  • specialized exercise training
  • keep fit/group exercise
  • manipulative therapy
  • reduction of joints, fractures and POP immobilization / splinting

OTHER SPECIALISED SERVICES

1. Renal Dialysis.

This will be offered to the patient inpatient or outpatient.

2 Drug and Rehabilitation services

Members are entitled to treatment in an accredited rehabilitation centre.

 

These services above 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 inpatient and outpatient (ambulatory) care

3. Drugs and essential medical supplies

4. Hospitalization ( in-patient care) when needed

5.Dental care

6. Referral where necessary

7. Any other benefits as may be reviewed and approved by the NHIF Board Tertiary care such as specialized surgery, chronic diseases management intensive care, and cancer therapy may be covered once a program for the same is put in place.

For any questions regarding NHIF Benefits, call their customer care service via (020) 272 3246 or contact them on social media using the links below:

Twitter: @nhifkenya

Facebook: NHIF KENYA

Important Links 

1.How To Check your NHIF Account Contributions Status

2.NHIF Penalties For Late Payments in Kenya

3.NHIF Outpatient Hospitals List in Nairobi

4. List of All NHIF Outpatient Hospitals In Kenya

5.Updated List Of NHIF Rates

6. NHIF Mpesa Transaction Charges for Self Employed Kenyans

7. How to Pay For NHIF Using Mpesa

8.How To Register For NHIF In Kenya

9.  List of All NHIF Branches in Kenya

10. List of NHIF Hospitals Allocated To Civil Servants in Nairobi

11. How To Pay NHIF Penalty Through Mpesa