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NHIF Outpatient Services



NHIF offers outpatient services to Kenyans with NHIF cards.

The National Hospital Insurance medical scheme is a social health insurance operated by NHIF. The scheme commenced out-patient services in July 2015. The scheme is yet another of the various health insurance products offered by the NHIF such as Civil Servants & Disciplined Services Medical Cover, Health Insurance Subsidy Programme for the poor, and elderly and people with severe disabilities. The National Health Insurance Scheme is affordable and all inclusive with the following features:
i. No exclusions for all medical conditions except cosmetic procedures
ii. No upper age limit for members to join
iii. No limitation on the number of declared dependants
The national scheme seeks to ensure that every individual and/or family enjoy comprehensive In-patient and Out-patient covers to save them from the effects of unpredictable and catastrophic spending on medical bills. The national scheme is a social comprehensive cover and health facilities have been contracted by NHIF country wide to provide the services under the scheme. NHIF acknowledges that many families without health insurance cover have been pushed into abject poverty and inhumane treatments such as detention in hospitals for their inability to pay medical bills or worse still, by disposing off valuable family assets.

Equipment for Specialised Treatment

In line with the comprehensive nature of the scheme, NHIF has been in the forefront to ensure that members are offered quality, affordable and accessible medical services. Indeed, in the recent years the NHIF has equipped five Referral Hospitals with renal dialysis machines and consumables so as to facilitate access to quality healthcare especially in dealing with chronic and otherwise difficult diseases. The following major health facilities have been assisted; Kenyatta National Hospital Nairobi, Moi Teaching and Referral Hospital Eldoret, Nakuru General Hospital Nakuru, Coast General Hospital Mombasa and Jaramogi Oginga Odinga Referral Hospital Kisumu. In addition, the Fund has donated highly equipped boat ambulances for use in difficult areas such as Lamu and Lake Victoria region.

Contracted Health Facilities and Benefits Package

NHIF has so far contracted various health facilities spread across all counties to provide comprehensive out-patient benefits to the members across the country under the national scheme. These benefits are for both In-patient and Out-patient services as follows:

  • (a) Out-patient cover
  • (b) Inpatient Cover offered in hospitals classified in categories A,B, & C covers the following:-
  • (c) Maternity Cover
  • (d) Renal dialysis package
  • (e) Drugs and substance abuse rehabilitation package
  • General Consultation
  • Diagnostics and treatment of common ailments
  • Laboratory and investigation
  • Prescribed Drugs administration and dispensing
  • Management of chronic ailments (HIV/AIDS, Diabetes, Asthma, Hypertension, cancer)
  • Health and wellness education/healthcare counselling such as Screening for conditions e.g Cervical and prostate cancer.