NHIF outpatient diseases covered and services offered

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It’s good to check the list of diseases covered NHIF and services offered before going to a particular hospital. Below we have a list of all the outpatient diseases covered and services offered:

a) Radiological Services package

It includes coverage for Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) scan, and Ultra Sound.
b) Cancer Package / Oncology Package

It includes coverage of Chemotherapy, Radiotherapy, and Brachytherapy for cervix and prostate cancer. For up to 10 sessions annually.
c) Renal Dialysis and Kidney Transplant Package

It includes coverage of Dialysis up to twice per week, kidney transplant package where the donor is covered as well.
d) Surgical Package

It includes coverage of minor, major, and specialized package.
e) Maternity Package

It includes coverage of normal and caesarian deliveries in Category A and B hospitals.
Services Covered Under The Out-Patient Package

NHIF has so far contracted various health facilities spread across all counties to provide comprehensive out-patient benefits to the members across the country under the national scheme. These benefits are for both In-patient and Out-patient services as follows:

1) Out-patient cover

– General Consultation
– Diagnostics and treatment of common ailments
– Laboratory and investigation
– Prescribed Drugs administration and dispensing
– Management of chronic ailments (HIV/AIDS, Diabetes, Asthma, Hypertension, cancer)
– Health and wellness education/healthcare counselling such as Screening for conditions e.g Cervical and prostate cancer.
– Treatment of sexually transmitted diseases
– Radiology Services
– Family planning/midwifery/ante/post-natal services
– Physiotherapy Services
– Referral for specialized services

2) Inpatient Cover offered in hospitals classified in categories A,B, & C covers the following:-

– Consultation
– Hospital daily charges
– Nursing care
– Prescribed diagnostic laboratory or other medically necessary services
– Physician’s, surgeon’s, anesthetics’ or physiotherapist’s fees
– Operating theatre charges
– Specialist consultations or visits
– Prescribed drugs/medications and dressings

3) Maternity Cover

– Consultation and treatment for both mother and child
– Child birth including caesarian section deliveries
– Family planning services

4) Renal dialysis package

5) Drugs and substance abuse rehabilitation package

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