National Hospital Insurance Fund is a State Parastatal that was established in 1966 as a department under the Ministry of Health. The original Act of Parliament that set up this Fund in 1966 has over the years been reviewed to accommodate the changing healthcare needs of the Kenyan population, employment and restructuring in the health sector. Currently an NHIF Act No 9 of 1998 governs the Fund.

NHIF registers all eligible members from both the formal and informal sector. For those in the formal sector, it is compulsory to be a member. For those in the informal sector and retirees, membership is open and voluntary.

To register with NHIF as a member, fill in the Members Form. To register as an employer or organized group, fill in the Employers Form.

Members Form Requirements
Employers Form Requirements

• Upon admission in hospital an NHIF member is accorded services and the hospital makes a claim to the Fund for reimbursement
• An in-patient cover for the contributor, declared spouse and children
• Provides comprehensive medical cover in majority of over 400 accredited Government facilities, Mission health providers and some private health providers across the country
• Provides in-patient services in private and high cost hospitals on a co-payment basis
• Comprehensive maternity and CS (Caesarian) package in government hospitals, majority of mission and some private hospitals
• Dialysis at Kenyatta National Hospital & Moi Teaching & Referral Hospital at a rebate
• Family planning – Vasectomy and Tubal Ligation
• NHIF does not exclude any disease.
• Proposed Benefits

Formal sector employees' contributions are deducted and remitted to the Fund by their employers. This is done by Cheque or through E-banking.

For members under the voluntary category, they pay Kshs.160 per month (Kshs.1920 per annum). For those in formal employment, contributions are made as per their income.

Claims are submitted by hospitals directly to NHIF after the contributors have been discharged from the hospitals. The claims are examined by the Fund to ensure validity before payment.

A claim can however be rejected and the hospital informed accordingly to incorporate either the missing documents or to address the abnormalities identified.

The Fund strives to pay claims within 14 days upon receipt of the claim from the hospitals. Members who opt to clear the bills with the hospital may launch a general claim directly to NHIF for reimbursement.