The New NHIF rules meant to screw Kenyans

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New NHIF rules
  • 3 weeks ago
  • Posted: January 9, 2020 at 4:12 pm

NHIF adds to Kenya’s woes.

The breaking news for January 1st 2020 was that KRA will slap small and medium enterprises with a 3% turnover tax. The tax will mean some SMEs will have no option but to close the business they are currently doing. An example is a business that makes a monthly profit of shs 5 thousand from a revenue of shs 100,000. That business will be forced to give up shs 3 thousand of the gross profit as tax and take home a paltry shs 2 thousand.

Hardly one week before Kenyans can digest the implications of that announcement, NHIF adds salt to injury by introducing a number of changes to “Management Module” of NHIF membership. Through a circular dated 7th January 2020, NHIF has announced changes to memberships as follows:

1. Revision of the waiting period for new voluntary National Scheme members from current 60 days to 90 days and introduce a 1 – year (12 months) upfront payment, payable within the waiting period while observing the due dates, before one can be eligible for any of the benefits.

2. Penalty on defaulting beneficiaries to stand at 50% of the monthly contribution for each month paid late, up to 11 months, coupled with requirement to pay for one year in advance and a restriction of 30 days before being eligible for benefits.

3. In case of the default for 12 months and above, the affected member will start payment afresh and be eligible for benefits after 90 days from the date of resumption of payment in addition to a 1 (one) year (12 months) upfront payment, payable within the waiting period while observing due dates otherwise rule number 2( above, will also apply.

4. For voluntary members access to maternity benefit be restricted to 6-months post card maturity for principal members or spouse declared at the point of registration.

5. For both maternity and specialized services, any dependent declared after initial registration shall be subjected to a 6-month waiting period after such declaration with the exception of newborns who shall be considered eligible for the benefit provided they are declared within 6 months from the date of birth. For medical inpatient and medical outpatient additional dependents shall be eligible for benefit after 30 days waiting period. This waiting period of 30 days will also apply in case of change of spouse.

6. Eligibility to access to specialized services shall be restricted to 6-month waiting period following card maturity for new members, while for defaulters, there shall be payment of all penalties and 1-year upfront payment of contributions coupled with a 30-day waiting period thereafter.

7. For National Scheme members, number of dependants per card to be limited to a maximum of (1) one spouse and (5) five children. For Managed scheme it will be capped at M+6 and M+1 for normal and retiree schemes respectively. Additional dependants can be included subject to payment of additional premiums to be communicated after actuarial valuation.

In summary, shs 6,000 is what you will need to pay upfront then wait for 90 days before you can start enjoying the benefits of NHIF, if you are one of those whose premium is shs 500 a month.

See also: Clarification on NHIF contributions and issuance of cards

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Odipo Riaga
Managing Editor at KachTech Analytics Ltd
Film Director, Tech and Business Blogger, Chess Player, and Photographer. God is Science.
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