What do NHIF Hospital Categories A, B and C Mean?

NHIF accredited hospitals that are contracted to provide inpatient medical cover for its members are grouped into 3 categories: A, B and C.

As a NHIF registered member you need this information when selecting your facilities as it determines the amount NHIF will cover for your inpatient expenses.

Under Category A hospitals, you receive a full and comprehensive inpatient cover including for maternity and surgical services provided they’re fully paid compliant members.

This means you will not be required to pay anything on admission. Category A hospitals include all public hospitals including:

Under Category B hospitals, you receive full and comprehensive inpatient cover similar to Category A but you may be required to co-pay where surgery is involved.

Category B hospitals include Private hospitals, Mission (Faith-based) hospitals and NGO hospitals.

Under Category C hospitals, NHIF covers only for specified daily benefits (e.g. bed charges). Category C hospitals include mainly Private hospitals but some Mission (Faith-based/NGO) hospitals are also contracted under this category.

How to Identify a Hospital’s NHIF Category?

In the Profile tab of most facilities listed on HOSI, there’s an NHIF section where you can find the hospital category.

nhif category hosi

For hospitals that are not listed or that don’t have the category indicated, please visit the NHIF website and search for the hospital manually to find its category.

Note however that we source this information from the website which likely means if it’s not already indicated it may probably be missing on the NHIF website too.

For such cases, we recommend that you directly contact the hospital and ask them to provide you with this information using the contact information or social media pages available on their Profile tab.

You may also get this information by contacting NHIF via [email protected] or by calling 020 2723246 / 0800 720 601 (Toll Free).

Comments

  • Irene Ilaria
    February 4, 2021 at 5:11 pm

    I was happy With Nhif from the time I started using it…but today am a disappointed client after I visited a hospital and I was told I don’t have funds for out-patient’s services..
    I have been going to many hospitals and have never been told about that..
    I was informed that my outpatient cover is only 100,000kshs and I have exhausted it from July to date.My questions is,how much is allocated for a civil servant in job group”L”,and how is is calculated?I have previously visited other hospitals and I have never been told that,even when I was in lower job groups..There is something that has to be elaborated for clients to understand..
    Thank you

    • Hosi
      February 5, 2021 at 11:05 am

      Hello Irene,
      Sorry to hear about your experience. I’ve looked into the limits for job group ‘L’ in the Civil Servants Handbook that’s available here and it seems they’re correct – the outpatient limit is 100,000 and in-patient limit is 1,000,000. Only job groups A-K have unlimited limits for both.

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