4 NHIF Schemes You Should Know

The National Hospital Fund (NHIF) is a state parastatal established in 1966 as a department under the Ministry of health. As time went by, NHIF was transformed from a department under the ministry of health to a state corporation. The move was initiated by the need to improve effectiveness and efficiency. NHIF’s main mandate is to provide medical insurance cover to all its members and their declared dependents (spouses and children). Through the 4 NHIF schemes, the fund ensures efficient health insurance for its members.

The 4 NHIF schemes available today are:

  • The National Scheme (Supa Cover)
  • Managed Schemes (Fee for Services – FFS)
  • Linda Mama
  • Edu Afya

NHIF membership is open to all Kenyans aged 18 years and above. You can register for NHIF either as an employed or self-employed person. However, the amount you will contribute either as an employed or self-employed member varies. Therefore, it’s necessary to check out the current NHIF rates to know what will be deducted from your salary.

Current NHIF Schemes

1. The National Scheme (Supa Cover)

The NHIF National scheme (Supa Cover) enables members to enjoy all benefits in the Supa Cover Benefit Package. If you are a self-employed member, you are automatically in the National Scheme (Supa Cover) which costs Kshs. 500 per month for the principal members and beneficiaries.

If you are in formal employment and not in any managed scheme, you are automatically in the National Scheme (Supa Cover). Members of the National Scheme can access services from Category A and some Category B hospitals.

Supa Cover Benefit Package

As a Supa Cover scheme member, here are the NHIF benefits you are entitled to:

  • Outpatient and Inpatient services
  • Maternal care
  • Reproductive health services
  • Radiology imaging services
  • Drug and substance abuse rehabilitation
  • All surgical procedures and transplants
  • Emergency road evacuation services
  • Cancer treatment
  • Renal dialysis
  • Overseas treatment

Find out: How to Check Your NHIF Status Online

2. Managed Schemes (Fee For Services – FFS)

The managed scheme covers persons whose employer has negotiated an additional enhanced package than that of the National Scheme. In most cases, this scheme covers the following groups of employees:

  1. Civil servants
  2. The National Police and Prison Services
  3. Government Parastatal employees
  4. County Governments
  5. Former Members of Parliament

However, not all members in the above categories access the managed scheme services. At times, services vary by job group and specifications by the employers. If you are a Managed Schemes member, you can access services in any of the category A, B & C hospitals.

3. Linda Mama

Linda Mama is among the 4 NHIF schemes in Kenya. This is the government’s expanded free maternity program administered through NHIF. The Linda Mama scheme covers:

  1. Four pre-natal clinics
  2. Four post-natal clinics
  3. Delivery (Both normal and C-section deliveries) in all NHIF-accredited clinics countrywide.

4. Edu Afya

This is a comprehensive medical scheme for all public secondary students. The scheme covers all students in the National Education Management Information System (NEMIS) and registered with NHIF.

Edu Afya members can access services from category A and some of the category B hospitals.

How to Check NHIF Schemes

You can check NHIF schemes in four ways as follows:

  1. Sending a text message with the format [ID {space} Your ID Number] e.g. (ID 01234567) to 1550.
  2. Using the USSD approach. Dial *155# and follow the prompt.
  3. Use the ‘My NHIF‘ app. You can download this app from Google Play and App Store
  4. Using NHIF online selfcare platform.