An estimated five million Kenyans are unable to pay their monthly premiums to the National Health Insurance Fund (NHIF) putting their families at further risk during the pandemic.
The national insurer’s CEO Peter Kamunyo has revealed that only 5 million Kenyans are actively paying their monthly premiums out of a pool of 10 million subscribers.
The gloomy position on the state of Kenya’s health insurance is largely attributable to the tough economic times sparked by Covid-19 pandemic.
NHIF chairman Lewis Nguyai adds that the dormant accounts are draining the scheme, noting that for every shilling received by a member, the insurer pays Sh2 per claim.
Speaking during the signing of the memorandum of understanding with the Boda Boda Safety Association of Kenya for Universal Health Coverage of riders in Nairobi, Mr Nguyai said the deal will benefit over five million Kenyans who rely on the Boda Boda industry.
“People should know that having an NHIF card will come in handy someday. It’s just Sh500 per month and Sh17 per day and the benefits are massive,” he said.
Meanwhile, patients will now be required to exhaust their private insurance before using NHIF to pay for their specialized treatment services.
The move comes after NHIF said it will cut down payment for specialized services such as surgeries, rehabilitation for drugs and substance abuse, emergency road evacuation, and imaging services such as X-RAYS, CT scans, and MRI.
“Once the patients exhaust their private cover while seeking treatment for those packages, we will pay the remainder of the fees,” noted Mr Kamunyo. Adding that paying for the specialized services makes the current NHIF model unsustainable.
According to the Health Financing Reforms Expert Panel Report, NHIF booked losses catering for specialized and major surgeries, where the average cost per claim range between Kes263,000 and Kes86,592.
According to the Kenya Revenue Authority, payroll taxes dipped by Kes 37.13 billion in the financial year ended June 2021, reflecting the impact of Covid-induced layoffs and pay cuts on a tough labour market.
“Employees contribute through statutory deductions” but half of them pay less than Ksh500, which means half of them pay the same as those in informal sectors,” said Mr Kamunyo.