NHIF plans to expand medical cover in June
Posted Saturday, April 7 2012 at 22:30
- Currently it caters for the principal member, spouse and three children
The comprehensive medical scheme for civil servants will be expanded in June to cover all members of their families.
Currently the cover, which is also designed for teachers and members of the disciplined forces, caters for the principal member, spouse and three dependent children under 18 years of age and up to a maximum of 25 years if still a full time student.
On Saturday, National Hospital Insurance Fund CEO Richard Kerich said that if their negotiations with the government bear fruit, then this will be implemented within the next two months.
Asked whether the expanded cover will include those who have more than one legal wife, he said: “We do not want to send the wrong signals . . . we don’t encourage that but it doesn’t mean we shall not treat them. We have provided a small window for it.”
He spoke as MPs continue to query how the multi-billion-shilling scheme -- unveiled in January -- was being implemented.
The House Committee on Health, led by Nyaribari Chache MP Robert Monda, had questioned the insurer’s choice of service providers and whether those accredited had the capacity to offer the services needed.
The committee also questioned how two private healthcare chains – Clinix Health Care Limited with 56,747 and Meridian Medical Centre with 32,824 members – signed up more than 40 per cent of the 221,730 eligible civil servants.
They also expressed worry about the insurer’s decision to pay accredited hospitals and clinics in full before they deliver their services. More than Sh1.08 billion is said to already have been sent out to 1,170 hospitals.
The MPs now fear that NHIF may run into trouble with the experimental scheme unless standards are set for the service provider to avoid fraud or theft of billions of funds meant to benefit government workers.
The national insurer’s top officials are expected to appear before the committee this week to shed more light on the scheme.
However, in an interview on Saturday, Mr Kerich explained that NHIF did not, in any way, influence which health service providers were to be included in the scheme. At least 1,544 health providers have signed up for the scheme.