Benefit Tariffs for New SHIF Scheme Revealed

The Ministry of Health (MoH) has issued new tariffs for the benefits package within the recently introduced Social Health Insurance Fund (SHIF) scheme.

In collaboration with the Social Health Authority (SHA) board, the specified tariffs for the SHIF benefits package remain subject to additional discussions with individuals who may be impacted. Additional consultations with relevant stakeholders regarding the proposed tariffs are scheduled to take place.

Health CS Susan Nakhumicha has extended an invitation to interested members of the public, stakeholders, and organizations to submit their views on the proposed tariffs.

The rollout of SHIF is anticipated by the end of June, with President William Ruto expected to inaugurate the registration process during this period.

The Ministry of Health will spearhead a mass registration exercise starting on June 21, 2024, across all platforms.

RELATED – CS Nakhumicha Clarifies New SHA Health Insurance Registration Process

Below are the proposed tariffs outlined within the SHIF:

Outpatient care services rendered in Level 2, 3, and 4 primary health care referral facilities designated by the Authority will incur a fee of Kes.2,000.
The Ministry clarified that certain services such as ARVs, HIV testing and follow-up tests, family planning commodities, antimalarial medication and testing, anti TBs and testing, and KEPI vaccines will be provided free of charge.
Inpatient services at Level 4-6 hospitals, with an admission limit of up to 50 days, will be charged at Kes.3,500 in Level 4, Kes.4,000 in Level 5, and Kes.5,000 in Level 6.
Maternity, Newborn, and Child health services availed in Level 4-6 healthcare facilities will incur a tariff of Kes.11,200 for normal delivery and Kes.32,600 for cesarean section.
Renal care packages at Level 4-6 facilities will require patients to pay Kes.10,500 for Hemodialysis and Hemodiafiltration services per session, along with a monthly fee of Kes.180,000 for Peritoneal dialysis.
Mental wellness packages at Level 3-6 facilities will cost Kes.1,200 for outpatient services and Kes.3,400 (Level 4), Kes.4,000 (Level 5), and Kes.5,000 (Level 6) for inpatient services.
Rehabilitation services will cost Kes.14,000 and Kes.125,000 respectively.
Oncological services in Level 4-6 facilities will include a fee of Kes.5,000 for chemo administration, Kes.53,000 for PET Scan, Kes.9,600 for CT-Scan, and Kes.11,000 for MRI. Additionally, bone scans will cost Kes.15,000, Radionuclide scan Kes.11,000, and Brachytherapy up to Kes.40,000.
Medical imaging packages accessible in all facilities will include tariffs of Kes.11,000 for MRI, Kes.9,600 for CT scans, Kes.8,000 for CT Angio, and Kes.4,000 for Fluoroscopy. Mammography services will cost Kes.3,000, special ultrasounds Kes.5,000, and Echocardiograms Kes.3,500.
Pharmacy packages in all public pharmacies will be provided free of charge.
End-of-life services, specifically the preparation of a body in a mortuary, will incur a fee of Kes.500 per day, with a maximum limit of five days.

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