The National Hospital Insurance Fund (NHIF) is set to partner with county governments to provide free medical cover to poor households.
The public health insurer said Nairobi, Bomet and Vihiga counties have pledged to set up safety nets to cover vulnerable groups in a new campaign that will see the elderly, orphans and those with disabilities have their medical bills in public hospitals footed by county governments through NHIF.
The fund is set to meet with governors on Friday in Naivasha to discuss the social protection.
Bomet County NHIF chairman Mohamud Ali said the parastatal has offered to provide cover for 15,000 poor households for a year under the programme.
“Governor Kidero (Nairobi County) has also pledged to put a number of households in the social protection scheme after we partnered last week,” said NHIF chief executive Simon ole Kirgotty said in an interview.
About 500 households from Kibera were recruited into the scheme during the partnership courtesy of several MPs.
The health provider is now shifting focus to the neglected bottom of the social pyramid to achieve universal healthcare, with a target of registering more than 10 million new members by year end.
Mr Kirgotty said the fund plans to mount a nationwide campaign targeting low-income households as it seeks to establish ties with counties — under which healthcare services fall — in the provision of accredited, quality medical care.
“We are targeting the majority in the informal sector including mama mboga (vegetable vendors), boda bodas, street vendors, among others,” he said.
Only 1.5 million households or a third of the fund’s 4.5 million members are from the informal sector, with the rest remitting their monthly contributions through employers.
Several private insurers have developed low-cost medical policies in a bid to capture the broad informal sector.
The perception, Mr Kirgotty said, has been that the NHIF cover is only for those formally employed.
A household contributes Sh160 per month towards the scheme, covering in-patient expenses for the nucleus family–contributor, one spouse and children.
Policy holders can access comprehensive medical cover in government hospitals and faith-based facilities, including maternity and surgical services.
It also includes renal dialysis at the Kenyatta National Hospital and the Moi Teaching and Referral Hospital and family planning.
At the moment, the scheme does not cater for out-patient services.
NHIF has also linked with several private hospitals including the Aga Khan, Nairobi and Mater hospitals to provide medical services to members. However, it only offsets a member’s bill up to Sh2,400 a night for those who opt for private facilities, with extra costs footed by the policyholder.
The medical scheme covers up to 180 days for in-patient care in both public and private hospitals.
NHIF has in the past been dogged by controversy over mismanagement that has seen several heads roll, the latest being three top managers in charge of finance, operations and benefits and equity.
“The ongoing audit found them unfit to continue serving. We want to get it right this time round. All cases of corruption will be dealt with accordingly,” the CEO declared.
Last year, the fund met resistance from employers after it proposed an increase in monthly remittances by employees. It had proposed monthly contributions of between Sh150 and 2,000 depending on one’s salary.