NHIF Comprehensive and Non-comprehensive Cover

While NHIF provides a comprehensive health cover called ‘Supa Cover‘ to all its members, the benefits a member can get from it depend ultimately on their choice of hospital.

Until recently, NHIF accredited hospitals contracted to provide inpatient services to its members were categorized into three categories i.e A, B and C. These categories have since been updated into two, namely: comprehensive and non-comprehensive.

This change makes the categories much easier to interpret as the meaning is in the words themselves. Let’s take a look at both.

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Comprehensive vs Non-Comprehensive Hospitals

As the name suggests, hospitals in the comprehensive category are contracted to provide a comprehensive inpatient cover to NHIF members. This means that the members will not pay out of pocket for any inpatient services when admitted in hospitals in this category.

This category includes all public hospitals and some select faith-based (mission) and private hospitals.

As for hospitals in the non-comprehensive category, NHIF may not cover for all inpatient services. NHIF members that use these hospitals may therefore be expected to pay out of pocket for some inpatient services. Usually this involves a co-payment, whereby NHIF covers the cost of specified services (e.g. bed charges) and the member covers the rest out of pocket (e.g. surgery)

Unless it’s an emergency, it’s therefore vital that members know the category a hospital belongs to before seeking any inpatient services from it, as this may save them expensive hospital bills.

To check the category a hospital belongs to, head over to the inpatient hospital listing on the NHIF website and search for your preferred facility.

Comments

  • Justus Mokua
    March 16, 2022 at 7:50 am

    Can I register super cover Im self emply

    • Peter Nyamongo
      July 10, 2022 at 5:29 pm

      Please reply

      • Peter Nyamongo
        July 10, 2022 at 5:30 pm

        Please send me the response

        • Hosi
          July 10, 2022 at 7:05 pm

          Yes, you can register for NHIF self-employed where you pay Ksh500 monthly or Ksh6000 yearly. This will cover you and your dependents (wife, children).

  • George
    August 23, 2022 at 11:50 am

    How long does it take after u enroll as anew nhif member and u pay 500 for you to b able to use the service

    • Hosi
      August 23, 2022 at 3:59 pm

      Hello George, it takes 60 days (2 months) to access the services.

  • Samuel munywoki
    August 24, 2022 at 2:31 pm

    If my premiums are paid by my employer is my card comprehensive?

    • Hosi
      August 24, 2022 at 5:01 pm

      The NHIF cover is comprehensive for everyone, whether employed or self-employed. What NHIF will cover however will be determined by the hospital you access a service from as explained in the article.

  • Chris
    August 31, 2022 at 3:54 pm

    I called your offices today wanting to know if a procedure my dependant is to go thro will be covered fully since am planning to send him to a comprehensive hospital from your list of comprehensive hospital and i was told NO. This contradicts what is on your website. Kindly clarify what one of your officers meant by National cover and comprehensive cover.

  • Chris
    September 1, 2022 at 2:42 pm

    Am still waiting for an answer to my question.

    • Hosi
      September 1, 2022 at 4:21 pm

      This site is not affiliated with NHIF.

  • Chris
    September 2, 2022 at 11:15 am

    Am still waiting for an answer to my question.

  • lawrence
    October 18, 2022 at 11:09 am

    why are you limiting us to certain hospitals.You need to restructure the MOUs and allow us as nhif contributors to go to hospitals where we feel our health will be taken care-off well.

  • Calvince
    October 25, 2022 at 6:23 pm

    Something am yet to fully understand: There are both comprehensive and Non-comprehensive covers. How does one qualify for a comprehensive cover. Is the monthly deductions/pay the same? Coz my thinking is comprehensive members pay more. Right? How much? If the pay is same, then how can I get into the comprehensive category.

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