NHIF rates 2022 for employees: Benefits and penalties calculated

National Insurance Fund (NHIF) is a state parastatal agency under the ministry of health. It accommodates various healthcare needs for several citizens. The fund’s principal mandate is to provide a medical cover to its members and their stated dependants such as children and spouses. In 2021, the agency changed its terms by incorporating new NHIF rates for salaried individuals.

NHIF membership is open to anyone who is a Kenyan and is above the age of 18 years old. However, one should have a monthly income of more than Ksh. 1,000. With close to 60 branches across the country, the agency services are readily available to the majority of employees and members. Below is everything you need to know about NHIF rates and penalties.

NHIF rates for employees

How much will you be paying per month to access medical insurance? What amount of money is your employer supposed to deduct? Note that this part does not apply to self-employed/voluntary members.

Below are the 2022 payment criteria for the employed in various salary brackets. Self-employed/voluntary members pay Ksh. 500 per month.

  1. Ksh. 0 to Ksh. 5,999 – Ksh. 150
  2. Ksh. 6,000 to Ksh. 7,999 – Ksh. 300
  3. Ksh. 8,000 to Ksh. 11,999 – Ksh. 400
  4. Ksh. 12,000 to Ksh. 14,999 – Ksh. 500
  5. Ksh. 15,000 to Ksh. 19,999 – Ksh. 600
  6. Ksh. 20,000 to Ksh. 24,999 – Ksh. 750
  7. Ksh. 25,000 to Ksh. 29,999 – Ksh. 850
  8. Ksh. 30,000 to Ksh. 34,999 – Ksh. 900
  9. Ksh. 35,000 to Ksh. 39,000 – Ksh. 950
  10. Ksh. 40,000 to Ksh. 44,999 – Ksh. 1,000
  11. Ksh. 45,000 to Ksh. 49,000 – Ksh. 1,100
  12. Ksh. 50,000 to Ksh. 59,999 – Ksh. 1,200
  13. Ksh. 60,000 to Ksh. 69,999 – Ksh. 1,300
  14. Ksh. 70,000 to Ksh. 79,999 – Ksh. 1,400
  15. Ksh. 80,000 to Ksh. 89,999 – Ksh. 1,500
  16. Ksh. 90,000 to Ksh. 99,999 – Ksh. 1,600
  17. Ksh. 100,000 and above – Ksh. 1,700

NHIF rates calculator

Well, you can make use of the widely available calculator programs online. You have to enter your basic salary and benefits to receive the figure. You can also refer to the NHIF rates to ascertain the charges.

NHIF benefits

By enrolling in NHIF, you will accrue the following benefits:

  1. Coverage against medical expenses: You will walk into and out of a specified hospital without having to pay for the services offered.
  2. Critical illness insurance: Whether its cancer, rehabilitation, or any surgical procedure that might be very delicate, NHIF will fund it.
  3. Cashless claim: You do not need any money as your bills are between the agency and the facility.
  4. Tax benefits: The sum of contributions are first deducted when calculating income tax.
  5. Drug costs: When available, the insurer will cover any medicines obtained from the hospital’s pharmacy or a chemist accredited by NHIF.
  6. Covers dependants: By paying the needed amount of money every month, your spouse, biological and adopted children can enjoy the insurance.
  7. Maternity: All the expenditures you/your spouse and new-born accrue are all paid.
  8. Private hospital access: Public hospitals sometimes might not be the best place to get specialized treatment. In that case, you can walk into accredited privately-owned hospitals such as Aga Khan and the rest.
  9. Family planning: Whether its injection, implant and anything else the doctor recommends, NHIF has got your back.
  10. No age limit: Even your 90 years old grandma can get medical insurance.
  11. Chronic diseases are covered: The fund will not exclude people suffering from illnesses such as HIV, cancer, asthma, hypertension, and diabetes.
  12. Cheap: For just a little sum of monthly contributions, you can get various services that would otherwise be expensive to pay through cash.
  13. Access to over 5,000 facilities: Accredited NHIF hospitals are in almost every part of the country.
  14. No screening for pre-existing sickness: Even if you currently have disorders such as leukaemia, no one will ask you during the registration phase.
  15. Caters for people with severe disabilities: If you fall under this category, you could reduce your medical expenses by joining the scheme.
  16. Dialysis at only Ksh. 2,500 per session: You can only receive the service in the certain institutions

Note that the scheme only pays for your hospital bills in recognized infirmaries. You cannot go shopping or buy any other goods and services using the issued card.

Can I use the NHIF card in any hospital?

Yes, and no. Recently the agency upgraded its system to enable its members to access inpatient services from any facility countrywide. It means that you can get emergency services that require at least an overnight stay from any accredited infirmary regardless of your location. It is contrary to the old system where you had to choose the preferred sanatoriums in this category.

For outpatient, you have to choose one hospital from which you will be receiving treatments that do not require admission. Note that you can also receive inpatient services from this facility if need be.

NHIF penalties

Self-employed individuals should pay Ksh. 250 on top of the monthly contributions when they make payments after date 9. If you have 2 months’ arrears, then the total amount will be Ksh. 1,500.

Employers should also submit employees’ payments in time. Failure to which, it attracts a consequence. Hence, in case of late submission, as an employee, you will not be charged anything extra.

NHIF contacts

For inquiries, reach out to the NHIF support team using the contacts below:

  • Physical location: Bandari Plaza 1st floor, Woodvale Groove Road, Westlands, Nairobi.
  • Postal address: P.O BOX: 30443 – 00100, Nairobi, Kenya
  • Inquiry email: customercare@nhif.or.ke
  • Complaints email: complaints@nhif.or.ke
  • Liaise email: info@nhif.or.ke
  • Fraud reporting: fraud@nhif.or.ke or (020) 271 4803
  • Fax: (020) 271 4806
  • Phone number: 0800 720 601

Frequently asked questions

Here are the most common questions about NHIF.

How do I pay my monthly contribution?

Your employer is responsible for submitting the amount to NHIF every month. In case you are self-employed, you can pay using M-Pesa and other alternatives. You should use 200222 as the Pay Bill number and your ID number as the account number. Deposit Ksh. 500 or Ksh. 6,000 for a whole year.

Does NHIF pay surgery?

Yes. The scheme caters for caesarean sections and any procedures involving organ transplants. What’s more, if you need specialized surgery from abroad that is not available in the country, all your medical bills will be paid.

What is NHIF Supa Cover?

It is the largest, reliable, affordable, and accessible medical cover that makes sure you and your family enjoy unparalleled benefits. For a small amount of money each month, all your medical bills will be covered by the scheme. Hence, you will be walking into specified hospitals and get particular services without paying a cent.

How much is NHIF Supa Cover?

The insurance will cost you Ksh. 500 per month. The amount is supposed to be paid by the principal member. Note that the amount covers your dependents too. Couples should produce their marriage certificate for registration.

What does Supa Cover entail?

As a member of this scheme, you will have access to the outpatient services and inpatient services, which are medical treatment procedures provided by a hospital or any other facility that requires at least an overnight stay.

Now you have NHIF rates, benefits and penalties. Don’t forget to pay on time to avoid the penalties.

DISCLAIMER: This article is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!

Dailyjobs.co,tz posted an article on how to check NHIF account status online. There is no need to go to the nearest NHIF branch to check your NHIF status. You can just do it online. Read the complete guide in the article.

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