Kenya - Apply for National Health Insurance Fund

ProcedureEdit

Apply In-Person

The applicant should visit the National Hospital Insurance Fund (NIHIF) offices or Huduma canter to make the application.
You will be given an NHIF Individual Registration Form or Employer Registration Form (depending on the nature of your application) to fill and submit.
The form may also be downloaded online and filled before visiting the offices for submission. The forms can be downloaded from the NHIF website and filled before visiting these offices for submission.
Fill in your personal detail, spouse details, children details and preferred out Patient Facility.
Proceed to make registration fees of Ksh 1500.
Attach copies of required documents for submission; This documents may include a copy of ID, Passport photo, marriage certificate if you are married, company PIN and company registration certificate and bank payment slip to the NHIF offices for processing.
Registration usually take a period of 7 days to complete. You must collect NHIF ID card in person. You are required to carry a proof of identity during collection.

Apply Online

Visit: NHIF Online registration portal
Select ‘’Employer ‘‘, ‘’Employee’’ or ‘’ self-employed ‘’ depending on which type or registration you qualify for.
After selection the application form page will load which you will have to fill in to complete.
Attach the required documents. This documents may include ; a copy of ID, Passport photo, marriage certificate if you are married, company PIN and company registration certificate
After uploading the documents, review you application details then click save. This will generate an online invoice with instructions on how to pay for your registration.
Proceed to make the payments for registration. As per the instructions given.
You will be notified of your status upon payment via email. In addition you will also receive an SMS to your number mobile number confirming payment of registration.
Print the acknowledgement of registration form and present it to any NHIF office or Huduma centre near you and get your card printed for you

Required DocumentsEdit

Kenyan Residents

Copy of National I.D (including spouse if applicable)
Copy of Employer Appointment/Introduction Letter (excludes self-employed/voluntary contributors)
Coloured passport photo (including spouse & dependants if applicable)
Original & copies of Birth Certificate(s) for dependants

Foreign Residents

Copies of passport, alien certificate or work permit (including spouse if applicable)
Coloured passport photo (including spouse & dependants if applicable)

Foreign Students

Copy of passport
Coloured passport photo
Submit the required amount under the Voluntary/Self Employed Category

Employers Requirements

Certificate of Registration
PIN Certificate

Office Locations & ContactsEdit

National Health Insurance Fund (NHIF) - Head Office
NHIF Building, Community Area, Ragati Road
P.O. BOX 30443-00100,
Nairobi, Kenya
Toll Free Telephone: 0800 720 601
Fax: (020) 271
Enquiry: [email protected]
Complaints: [email protected]
Email: [email protected]
Fraud: [email protected]
Website: NHIF Link

NHIF Desk - Huduma Center Huduma Center Locations

EligibilityEdit

Residents if Kenya
The individual needs to have attained the age of 18 years. (No age limit after the age of 18 years)
An individual whose total income from salaried or self-employment is more than Ksh. 1,000 per month or Ksh. 12,000 per year.
The individual needs to be drawing an income from Kenya
Individuals working under contract or casual terms of employment
Voluntary contributors, this includes foreign visitors permitted to work or study in Kenya

FeesEdit

The application is free of charge.
For members under the voluntary category, they pay Kshs.500 per month (Kshs.6000 per annum) as contributions. For those in formal employment, contributions are made as per their income.

ValidityEdit

Registration remains valid as long as monthly contribution are paid.
The cover becomes active after 60days from the day of registration.

Documents to UseEdit

Individual Registration Form: Individual Registration Form
Employer Registration Form: Employer Registration Form

Sample DocumentsEdit

Please attach sample completed documents which would help other people who would like to follow this procedure.

Processing TimeEdit

Processing and issue of membership card is…………7 working days
Issuing of urgent cards……………………………………… 1 day
Issuing of company and sponsor codes……………… 14 working days
Issuing of membership number……………………… Immediately

InstructionsEdit

Download the Registration forms; Individual Registration Form or Employer Registration Form or visit the NHIF online portal NHIF Online registration portal to make the registration.
Complete the application for registration by providing all the required details.
Make the applicable payments
Attach/ Upload the required documents and payment receipt to the application and submit to the NHIF for review and registration
Registration usually take a period of 7 days to complete. You must collect the registration certificate in person.
A proof of identification is required when collecting the certificate.

Required InformationEdit

Employment status
Preferred outpatient Medical facility
Member Details

(i) Identification Type

(ii) Identification Number

(iii) ID Serial Number

(vi) Full Name

(v) Date of Birth

(vi) Gender

(vii) Marital Status

(viii) Postal Address

(ix) Email/ Mobile No

(x) County of Residence

(xi) Nearest NHIF Branch Office

(xii) Employer/Organized Group Code:

(xiii) Sponsor Code:

(xiv) Payroll/Personal No.

(xv) Place of Residence (sub county)

Spouse Details

(i) Surname:

(ii) Other Names:

(iii) National I.D./Passport/Alien I.D. No.:

(iv) Date of Birth (DD/MM/YYYY)

(v) Gender (Male/Female)

(vi) Mobile Phone No.:

Employers

(i) Employer’s/ Organized Group/ Sponsor Particulars

(a) Name:

(b) Postal Address:

(c) Telephone Number

(d) E-mail Address

(ii) Headquarters’ Registered Office

(iii) Certificate/Registration Number (Attach copy)

(iv) Company PIN Number (Attach copy)

(v) Full Name of Authorized Officer<:br>

(vi) Employer’s/Organized Group Official Stamp

Need for the DocumentEdit

The fund currently provides medical insurance to all registered members alongside their dependents.
The NHIF document is usually needed by some employers before offering a job to a prospective employee.

Information which might helpEdit

National Health Insurance Fund was established in 1966 as a department within the ministry of health by an Act of Parliament mandated to provide health insurance to Kenyans over 18 years. For those who are employed (formal sector), it is compulsory to be a NHIF member. For those in the informal sector (self-employed) membership is voluntary.
If you are self-employed and have not contributed for 12 months and beyond your card will be deactivated. To can reactivate your NHIF card, pay at least KES 1,500 and resume usage of the card after 2 months (60 days). You can pay through M-PESA (paybill 200222) or at the Bank
To add your spouse to your NHIF card or beneficiaries, present a copy of your ID and marriage certificate or affidavit from the magistrates’ court to your NHIF centre or Huduma centre. For your child, avail his or her birth certificate or a birth notification if they are 0 to 6 months old.

Contributions & Deductions

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.500 per month (Kshs.6000 per annum). For those in formal employment, contributions are made as per their income.

Payment of Claims

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.

External LinksEdit

NHIF Benefit Package: NHIF Benefit Package
NHIF Registration NHIF Registration

OthersEdit

Accrediting & Contracting Hospitals

The Fund strives to accredit as many hospitals as possible so as to ensure all members access NHIF benefits whenever they are across the country.
NHIF has an objective accreditation criteria and guidelines that aim to encourage hospitals towards quality improvement.
Accredited organizations are those recognized by the Fund and allowed to offer services to NHIF members and claim reimbursements thereof.
Accreditation of a health provider takes into account the services, personnel, infrastructure and equipment among other issues that the institutions have. The level of rebate therefore corresponds to the grade after scoring the various aspects.
The Fund, further contracts the health facilities to ensure they provide services comprehensively. This means that NHIF members walk in and walk out of the facilities fully treated at the cost of NHIF without making additional payments.
The contracts spell out the obligations of the health provider and NHIF.