NHIF EDUAFYA Cover for all students – Requirements, benefits, application guide
When the government unveiled the National Education Management Information System (NEMIS) to manage our enormous education sector, there was just too much anticipation that we didn’t take a moment to appreciate what the new technology could bring.
Today, students in public schools are the biggest beneficiaries to access medical cover from the National Hospital Insurance Fund’s EduAfya product partly made possible by the database.
Back in 2018, the education ministry signed an agreement that would later on see students in public secondary schools get comprehensive medical insurance cover enjoying a range of services from both outpatient to inpatient medical services.
How to become eligible or join NHIF’s EduAfya product
To be eligible, one must be a student in a public Secondary School
student must be registered under the National Education Information System (NEMIS) database.
Must be Registered by NHIF.
EduAfya can only be utilized by primary policy holders; in this case, the student and is not transferable or cannot extend to any other dependent. The latest move puts NHIF on toes with leading technology innovators in the insurance sector such as Linda Jamii cover
How to Register for EduAfya Cover
You need not just be a student but registered on NEMIS for public school students
The student details are then shared by Ministry of Health to NHIF
Biometric registration will be done physically by NHIF at the respective schools
Benefit Package of EduAfya policy holders (students)
EduAfya Out-patient Benefits
These includes services that have to be administered by or on the order of a clinician/ physician who is licensed as a general practitioner.
Specialized Out-patient referred to by a general practitioner/Primary Care clinician where a member was registered.
General routine outpatient services as per Kenya essential package for health subject to policy terms and conditions.
The outpatient benefits those who are referred for specialized services such as; Drug and Substance Abuse Rehabilitation Services,
For those who may have an ailment relating to their dental health, they will be able to benefit from the following proceedures; Extraction, Root canal, Dental X-ray Services, Accident related inpatient Dental cases will be covered under the standard inpatient surgical benefits to the full inpatient limit.
EduAfya Optical Cover
An optional benefit that caters for expenses related to eye treatment, including the cost of; Consultation, Eye testing, Prescription for ophthalmic treatment and prescription of eye glasses, Accident related inpatient optical cases will be covered under the standard inpatient benefits to the full inpatient limit.
EduAfya Inpatient Services
Hospital accommodation charges ranging from bed costs and so on
Pre-hospitalization diagnostic services
Doctor’s (physician, surgeon & anesthetist) fees.
Nursing charges
Drugs/medicines, dressings and internal surgical appliances.
Diagnostic, laboratory or other medically necessary services
Rehabilitation services
Operating theater services
Radiological diagnostic e.g. x-ray services, CT scan, MRI, ECG
In-patient physiotherapy.
Day care surgery surgical procedures that do not require overnight stay.
