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The National Hospital Insurance Fund headquarters/FILE

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Why NHIF dues matter- Tito’s Story #InsuranceKenya


Tito was a little tense as he went to the accounts section of a local hospital to clear the medical bills. He was hoping that his bill would be completely settled by his new health insurance cover at his latest job posting, though he was not sure whether his wife and new son had exceeded the limit. His wife had been sent to the theatre for an emergency C-Section, and the baby arrived exhausted and in need of special care. Tito’s wife was discharged after five days, but the baby stayed on for another week. This is why Tito was scared. The health insurance company had called him three days earlier to discuss the limits for maternity care and for congenital illnesses, and indication that the bills were spiraling. Tito had initially tried to keep track of the growing bills, but somewhere between caring for his wife, and keeping up with the pediatrician regarding the state of the baby, Tito lost track.

Related:7 Insurance Tips When Planning For A Baby

As he walked down the hospital corridor, Tito couldn’t help but try to do mental calculations of how much the figure would come up to. He had an estimate of how much the hospital charged for C-Section, but he was not sure whether an emergency C-section cost the same. The baby’s hospitalization was a surprise, and the cost of care wasn’t in his initial estimates. That notwithstanding, his medical insurance cover included the cost of congenital illnesses, hence he wasn’t completely in the woods.

Tito asked the accountant for his wife and son’s bill and waiting pensively as the accounts assistant searched the records. She soon handed him a long itemized bill, typical of hospitals that accept insurance financing. The thickness of the bills would have rivaled a small edition of a national newspaper. The accounts assistant then explained that his wife’s cover was exhausted but thankfully, it was only by a few thousand shillings. The accounts assistant went on to hand him a bill of about Kshs 40,000. Tito didn’t get it! “why is my bill this big is the cover was exceeded by only a few thousand shillings?” he asked. “It is because you NHIF membership is inactive”, she replied. Tito stared at her blankly as he took in the news. He then remembered the email he had received from work asking him to furnish his new employer with his NHIF details. He went on paternity leave before forwarding his details and it had been about three months since his last submission.

Related:Health Insurance Guide for Expectant Moms and Dads 

After a few calls, Tito found a way round the problem, but was only lucky because his new employer could fix it. It would have been a very expensive turn of events considering he was only behind in his payments by less than one thousand shillings. He quickly remembered his friend Oscar whose wife was due in a week and called him up to ask him whether his NHIF details were in order. You see, Tito had learnt that having private insurance does not exempt one from participation in NHIF, and it can be costly to be behind in payments.

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