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.

By Editorial Team

The Education News Hub Editorial Team is made up of vibrant and experienced editors. Brian Yano is an accomplished longtime Digital Media Journalist at Educationnewshub.co.ke with a great passion for research and fact-checking. He delivers engaging content across diverse topics, with a special interest in Education matters. On her part, Yvonne Kemunto is a journalist, dedicated to unraveling stories that matter. With a keen eye for detail and a passion for storytelling, she brings a fresh perspective to the world of media. Her commitment to detail and excellence shines through in every piece she crafts. Our newest member of the Editorial Team is Jennifer Mumbo. She is a Seasoned Multimedia Journalist with several years' experience; dating back to 2018. Jennifer has a passion for education, sports, tech, politics and entertainment. You can reach the editors at educationnewshub3@gmail.com.