NHIF and New Benefits Package
From a struggling operation barely 10 years ago, the National Health Insurance Fund (NHIF) is now offering enhanced financial services, including treatment locally and abroad, an improved maternity cover, as well as full coverage of kidney dialysis and heart surgery costs.
Many patients still do not know that they must first seek pre-authorization from the NHIF headquarters, which involves having a form filled in by the attending doctors specifying whether they require chemotherapy or radiotherapy, the sessions needed, and any other drugs required, before they can be treated from an accredited facility.
NEW NHIF BENEFITS PACKAGE
Registration and Consultation
This covers costs related to registration and consultations in hospitals.
Medicines and medical supplies
Covers for the costs as per the National Essential Medicines List (NEMLIT) and additional medicine list recommended (to NHIF) by experts.
The Fund covers for the costs of investigations and diagnostic tests as per the investigation list in the benefits package. There are 321 medical investigations, including ultrasound, echo-cardiography, CT-Scan and MRI.
Includes minor, major and specialized surgical services in health centers all the way to referral hospitals.
Inpatient Care Services, including ICU and HDU
Covers for the daily admission costs depending on the level of the facility, investigations, medicines and medical consumables dispensed while the member is admitted.
Physiotherapy and rehabilitation services
This is provided to inpatients and outpatients where the facility has specialists for the same.
Eye and Optical Services
NHIF covers the costs for optical services to all beneficiaries (Treatment of eye diseases and refraction for visual defects).
The Fund pays for visual corrective spectacles to the principal member (one pair for a period of 3 years).
Dental and Oral health Services
This is provided to inpatients and outpatients where the facility has specialists for the same. This includes dental conservation surgeries (carries and dental filling), gum diseases, dental extractions and root canals.
Retirees Health Benefits
Comprehensive medical services are offered to the retired principal members and their spouses, for their entire lives.
The Fund provides supportive orthopedic and medical appliances, including white cane for blind people, neck and thoracic spine collars, hearing aids, lumbar cossets and braces, walking crutches and leg orthopedic supports — ankle, knee and above-knee supports.
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