What does shift from NHIF to SHIF mean for you?

Starting July 1st, 2024, access to healthcare will transition to the new Social Health Authority (SHA).

Under this system, each household will need to contribute 2.75 percent of their income as a statutory deduction, with a reduced minimum monthly contribution of Sh300, down from the previous Sh500 required by the National Health Insurance Fund.

The fund is broken down into four cost segments, which the government says will be both individually and publicly financed.

The benefits package components in the new SHIF include medical outpatient services, end-of-life services, surgical services, specialised pharmacy benefits, medical inpatient and critical care services, accident and emergency services, optical services, mental wellness services, specialized essential diagnostic services, renal care services, overseas treatment, dental healthcare services, rehabilitative services, screening for common diseases, assistive devices, maternity and child health services, oncology services and medical imaging services.

The benefits package includes health education, wellness, counselling, and ongoing support, which require a payment of Sh900 per person per annum at levels 2, 3, and 4.

The cost for maternity, newborn, and child health services at levels 2 and 3 hospitals is Sh11,200 for normal delivery and Sh32,600 for a caesarean section. This means the Linda Mama programme, which allowed expectant women free delivery services, has effectively been scrapped.

Screening and management of pre-cancerous lesions, as well as screening for common cancers such as breast, prostate, cervix, and colon, will be available at levels 2 to 6 health facilities. The fee for HPV screening will be Sh3,600.

Prostate cancer screening is covered for males over 55 years, colon cancer screening for males over 40 years, and cervical cancer screening for women between 30 to 50 years.

HPV screening will be for females aged 35 to 45 years. While cancer cases are on the rise among young people, they have been locked out with the age capitation.

For renal care, the access point will be level 3 to 6, and the cost for hemodialysis and hemodiafiltration will be as high as Sh10,650, an increase from the current Sh9,500.

The shift from NHIF to SHIF involves transferring funds for a seamless transition aimed at maintaining financial stability and uninterrupted health coverage.

Community health promoters will assist elderly individuals with registration to simplify the process. Instead of physical health insurance cards, individuals will receive a Social Insurance Fund number for easier access to health services and reduced administrative burdens.

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