Here Are The NHIF Rates For 2023 in Kenya For Self And Goverment Employed
Everything you need to know about NHIF rates in Kenya for 2023: stay informed and covered with our ultimate guide.
Kenya's National Hospital Insurance Fund (NHIF) plays a pivotal role in the healthcare sector by providing affordable health insurance to its members and their dependents. The NHIF has recently updated its contribution rates and policy for salaried individuals and self-employed persons. This article provides a detailed overview of the changes and essential information regarding the new NHIF rates for 2023.
NHIF Registration: ABC...
Registering for NHIF is a straightforward process, and multiple methods are available to applicants. Following the outlined steps, you can register online through the NHIF Selfcare Platform. Alternatively, you can register by dialing the USSD code *155# from any network and following the prompts. Another convenient option is downloading the 'My NHIF' App from Google Play Store or Apple Store and registering through the application. The initial registration fee is KES 1,500, covering three months, followed by a monthly payment of KES 500 to maintain your membership and avoid penalties.
The New NHIF Rates: A Brief Overview
Since its inception, the NHIF has continually evolved to meet the growing needs of its members. It has expanded its scope of coverage and benefits and increased the contribution rates, all intending to provide quality healthcare services. The NHIF's new rates for 2023 have been revised in a way that offers better benefits for its members.
2023 NHIF Rates for Salaried Individuals
Salaried employees have a unique NHIF contribution structure. These rates are calculated based on the employees' gross income and represent a certain percentage of that income. This model ensures that contributions are fair and proportional across different income brackets.
The table below represents the new NHIF rates for employees in 2023:
| Employee's Monthly Gross Income (Ksh) | NHIF Rates Per Month (Ksh) |
|---|---|
| 0-5,999 | 150 |
| 6,000 - 7,999 | 300 |
| 8,000 - 11,999 | 400 |
| 12,000 - 14,999 | 500 |
| 15,000 - 19,999 | 600 |
| 20,000 - 24,999 | 750 |
| 25,000 - 29,999 | 850 |
| 30,000 - 34,999 | 900 |
| 35,000 - 39,999 | 950 |
| 40,000 - 44,999 | 1,000 |
| 45,000 - 49,999 | 1,100 |
| 50,000 - 59,999 | 1,200 |
| 60,000 - 69,999 | 1,300 |
| 70,000 - 79,999 | 1,400 |
| 80,000 - 89,999 | 1,500 |
| 90,000 - 99,999 | 1,600 |
| 100,000 and above | 1,700 |
These rates are mandatory, and employers must make these deductions and remit them to NHIF on behalf of their employees.
NHIF Rates for the Self-Employed
The NHIF recognizes that only some are formally employed. Consequently, the Fund has a unique arrangement for individuals in the informal sector, retirees, and self-employed persons. These individuals are required to make a monthly contribution of Ksh. 500, which totals to Ksh. 6000 annually.
Calculating NHIF Contributions
To calculate your NHIF contributions accurately, you can use the various online calculator programs available. These calculators require you to input your salary scale and benefits to determine the corresponding NHIF contribution amount. Additionally, you can refer to the NHIF deduction rates provided by the organization to ascertain the charges.
Understanding NHIF Penalties
Both employers and the self-employed must adhere strictly to NHIF payment deadlines. Payments should be made on or before the 9th of every month. Any payment made after the 9th will attract a penalty.
For the self-employed, the penalty is 50% (Ksh. 250) of the monthly contribution. They're considered new members if the default extends to more than 12 months. They will then have to pay Ksh. 1,500 as a three-month contribution and wait 2 months for their cover to be active.
For employers, a late payment will attract a penalty equal to 10% of the contribution amount. As such, timely payments are advised to avoid these extra costs.
The Scope of NHIF Benefits
NHIF Benefits
Enrolling in NHIF provides numerous benefits to its members. NHIF is Kenya's most extensive, affordable, reliable, and trusted medical insurance coverage. The following are the various benefits that NHIF members can access:
Inpatient Benefit Package
The inpatient benefit package is available to all eligible NHIF members and their dependents. It includes coverage for general and specialist consultation fees, prescription and dressings, operating theatre charges, diagnostic laboratory and radiology investigations, nursing care, bed charges, procedures and treatments, and more.
Outpatient Benefit Package
The outpatient benefit package covers medicine and dispensation, laboratory and radiology investigations (including x-rays and ultrasounds), consultations, day-care procedures, behavioral health services, counseling, therapy services, immunization, and more.
Maternity Benefit Package
NHIF offers a comprehensive maternity benefits package that covers pregnancy-related health services, including aftercare for both mother and newborn, cesarean section or expected delivery, and facilitation of labor.
Renal Dialysis Benefit Package
The renal dialysis benefit package covers hemodialysis, routine laboratory tests, dispensed and intra-care medications, dialysis, nursing services, specialist review, follow-up, and counseling care.
Oncology Benefit Package
NHIF provides coverage for the treatment of cancer patients, including immunotherapy, chemotherapy, brachytherapy, radiotherapy, pet scans, and other treatments as specified by the Ministry of Health.
Radiology Benefit Package
This package includes diagnostic imaging services for C.T. scans and MRIs. Note that ultrasounds and x-rays are covered under the outpatient and inpatient packages.
Emergency Care Benefits
NHIF covers onsite evacuation and transfer of a sick member or their dependents to the nearest NHIF-accredited hospital. It also covers ambulance services.
Mental and Behavioral Health Benefit Package
NHIF covers neurological disorders, common mental disorders, severe mental disorders, substance abuse disorders, and childhood disorders.
Surgical Benefit Package
The surgical benefit package covers all surgical procedures, including transplants. However, it excludes cosmetic or plastic surgeries.
Overseas Treatment
NHIF covers all treatment costs related to surgical and medical interventions unavailable in Kenyan hospitals.
NHIF Coverage in Hospitals
NHIF members and their dependents are not restricted to specific hospitals for inpatient services. They can access inpatient services in any hospital or facility accredited by the NHIF nationwide. However, members are limited to the accredited hospital they selected for outpatient services while applying for NHIF.
NHIF Insurance Coverage for International Treatment
NHIF has partnerships with renowned hospitals in various countries, including India. When applying for overseas medical treatment, following the specific guidelines provided by NHIF is essential. You must submit the filled application form to an NHIF office in person for medical treatment in India. Along with the application, you must collect and submit the following documents:
- Latest medical reports
- NHIF referral letter from the treating hospital
- NHIF card details
- National ID
NHIF-approved hospitals in India include:
- Apollo Hospitals
- Fortis Hospitals
- Max Hospital
- BLK Max Hospital
- Medanta Hospital
- Artemis Hospital
- Manipal Hospital
- Jaslok Hospital
- Aster Hospital
- HCG Cancer Hospital
- Cytecare Cancer Hospital
- Yashoda Hospital
- KIMS Hospital
- Care Hospital
- Aakash Hospital
- Sharda Hospital
- Metro Hospital
- Kokilaben Dhirubhai Ambani Hospital
- SL Raheja Hospital, and more.
What are the eligibility criteria for NHIF membership?
NHIF membership is open to all Kenyan citizens who are ordinarily residents of Kenya and have reached the age of 18. It is available to both employed and self-employed individuals. Eligibility extends to individuals above 18 years old who can apply for single or family membership. Family membership allows the inclusion of a declared spouse and children below 18 years of age. Notably, NHIF does not consider pre-existing conditions when assessing eligibility, making it accessible to many individuals.
NHIF Contact Information
If you have any inquiries or need assistance regarding NHIF, you can reach out to the NHIF support team using the following contact information:
- Physical Location: Bandari Plaza 1st floor, Woodvale Groove Road, Westlands, Nairobi.
- Postal Address: P.O. BOX: 30443 - 00100, Nairobi, Kenya
- inquiry email: [email protected]
- Complaints Email: [email protected]
- Liaise Email: [email protected]
- Fraud Reporting: [email protected] or (020) 271 4803
- Fax: (020) 271 4806
- Phone Number: 0800 720 601
READ ALSO: NHIF Byproduct Portal: Your Ultimate Guide
Conclusion
The NHIF plays a vital role in providing accessible and affordable healthcare coverage to Kenyans. In 2023, new NHIF rates for employees and the self-employed will come into effect, offering improved benefits for members. Individuals must understand their eligibility, contribution rates, and the benefits they are entitled to under the NHIF. By enrolling in NHIF and making timely contributions, individuals can enjoy comprehensive medical insurance coverage and access various healthcare services. It is always advisable to stay updated with the latest information and changes regarding NHIF rates and policies.
FAQs
How do I calculate my NHIF contributions?
- NHIF contributions are based on your gross monthly income. You can use online calculators or the NHIF deduction rates to determine your contribution amount.
What are the benefits of NHIF membership?
- NHIF membership covers various healthcare services, including inpatient and outpatient care, maternity services, renal dialysis, oncology treatments, radiology services, emergency care, mental and behavioral health services, surgical procedures, and overseas treatment.
Can I use my NHIF card in any hospital?
- NHIF members and their dependents can access inpatient services in any NHIF-accredited hospital nationwide. However, members are limited to the accredited hospital they selected during the NHIF application process for outpatient services.
What are the penalties for late NHIF contributions?
- Self-employed individuals who fail to pay their NHIF contributions by the 9th of each month will incur a penalty of 50% of the monthly contribution. Employers who fail to remit employee contributions on time may be liable to pay an amount equal to 10% of the contribution.
How can I reactivate my NHIF card after a default?
- If your NHIF card has been inactive for over 12 months due to default, you can reactivate it by paying the NHIF reactivation fee of Ksh. 1500. After reactivation, you must wait 60 days before you can use your NHIF card again.
Are there different NHIF schemes available?
- NHIF offers different insurance schemes, including the EduAfya Scheme for public secondary school students, the Linda Mama package for pregnant women and infants, the Civil Servants Scheme for all civil servants, and the National Supa Cover for individuals in formal and informal employment.
Disclaimer
The information provided in this article is based on the available information regarding NHIF rates for employees and the self-employed in 2023. It is subject to change, and individuals are advised to verify the latest rates and policies directly from the NHIF or their official website. The article does not constitute legal or financial advice, and readers are encouraged to consult with appropriate professionals for personalized guidance.
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