NHIF Services and Hospitals- Best Guide

Hospital Categories

There are three categories of hospitals namely:

1. Category A – Government Hospitals
2. Category B – Faith-Based and Medium Cost Private Facilities
3. Category C – High Cost Private Facilities

 

National Scheme (Supa Cover)

The NHIF National Scheme also called (Supa Cover) is a medical insurance cover that enables the member enjoy all the benefits outlined in the Supa Cover Benefit Package. All Self-employed members are automatically in the National Scheme (Supa Cover) which costs Kshs. 500 per month for the principal members and beneficiaries. Other employed members who are not in a managed scheme are also in the National Scheme (Supa Cover). Members in the National Scheme can access services from Category A and some of Category B hospitals.

Managed Schemes (Fee For Services – FFS)

The managed scheme covers persons whose employer has negotiated additional enhanced package than that of the National Scheme. It covers mostly civil servants, The National Police & Prison Services, Government Parastatals, County Governments & former members of parliaments. It is not constant factor that all members in the fore-mentioned access the same services. In some cases, it varies by job groups. Members in Managed Schemes can access services in any of Category A, B & C hospitals.

Linda Mama

Linda Mama is the Government’s expanded free maternity programme administered through NHIF that covers:

1. Four pre-natal clinics
2. Four post-natal clinics
3. Delivery whether normal or through the Ceasarian section through all NHIF accredited clinics nationwide.

Members on the Linda Mama Programme can access services in NHIF accredited hospitals that offer the Linda Mama maternity package.

Edu Afya

Edu Afya is a comprehensive medical scheme for all public secondary students covering all students captured under the National Education Management Information System (NEMIS) and registered with NHIF. Members on the Edu Afya scheme can access services from Category A and some of Category B hospitals.

Checking schemes

Once check the scheme they are in by sending a text message with the format [ID {space} Your ID Number] e.g. (ID 12345678) to 1550, by dialing *155#, using the ‘My NHIF’ App which can be downloaded from Google Play or App Store or the NHIF online Selfcare Platform.