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What's NHIF? How to submit NHIF returns

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NHIF stand for National Hospital Insurance Fund. It is one of the top  government corporations offering health insurance service to Kenyans who have attained the legal age of 18 years and even those below as beneficiaries.The corporation offers reliable, affordable, accessible and quality health insurance cover Kenyans. NHIF is aptly committed to ensure clients get sustainable services through a reliable timely customer care services.

Benefits Package of  NHIF

As an enrolled  member of NHIF, one is able to enjoy the following benefits:

In -Patient Cover-this applies for someone admitted in hospital(one can access any medical facility for in-patient services).It provides comprehensive medical cover in majority of over 400 accredited Government facilities, Mission health providers and some private health providers across the country. Provides in-patient and high cost hospitals on a co-payment basis.

NB:The services are provided as per the level of accredited facility and in accordance Clinical Guidelines for Management of Referral of Common illness Level 2-6(2009)

Out-Patient Cover-this applies for situations where a client obtains medical services without being admitted.Every member is required to choose one medical facility for outpatient services. The facility can be changed June and December every year.

NHIF ELIGIBILITY

Any person:

  1. Has age of 18 years.(No age limit after the age of 18 years)

  2. Whose total income from either salaried or self-employment is more than Ksh. 1,000 per month or Ksh.12,000 per year.

  3. Drawing an income from Kenya

  4. Working under contract  or casual terms of employment

  5. Voluntary contributors(includes foreign visitors permitted to work or study in Kenya)

NHIF REQUIREMENTS

The requirements differ depending on whether one is a Kenyan, foreign residents or foreign student.To register as a member, one is required to visit the nearest NHIF offices.

For a Kenyan citizens, the following is the requirements:

  1. Copy of national ID(including spouse where applicable)

  2. Copy of employer appointment(excludes self-employed/voluntary contributors)

  3. Colored passport photo(including spouse and dependants where applicable)

  4. Original and copies of Birth certificates of dependants

For foreign residents, the following is required:

  1. Copies of passport, alien certificate or work permit(including spouse if applicable)

  2. Coloured passport photo(including spouse & dependants if applicable)

For foreign students, the following is required:

  1. Copy of passport

  2. Coloured passport photo

  3. Submit the required amount under the Voluntary/Self Employed category

Employers Requirements

As an employer, NHIF provides the capability to enable one to make contribution on behalf of employees

  1. Certificate of Registration

  2. PIN Certificate

Contributions & Deductions

  • Formal sector employees’ contributions are deducted and remitted to the fund by their employers. This is done by cheque or through E-banking

         NB:Contributions are made as per one’s income

  • For members under the voluntary category, they pay Kshs.500 per month

PAYMENT CLAIMS

Claims are submitted by hospitals directly to NHIF after the contributors have been discharged from the hospitals.The claims are examined by the fund to ensure validity before payment.

PENALTY FOR  LATE PAYMENT(SELF-EMPLOYED/VOLUNTARY CONTRIBUTORS)

One is required to submit contribution by 9th of every month. Failure to this, one is charged a penalty fee.Going beyond any NHIF deadline attracts huge penalties which must be cleared for the insurance cover to remain valid.When an employer misses a payment, they are legally required to make double principal payments. For informal members, late payments attracts an extra fee of 50% the NHIF payment rates.

For instance, KEs. 250 on top of KEs .500 to make a total of KEs.750.

Making contribution via Mpesa

To submit one’s monthly contribution, one can has two options:

  1. Pay cash at any NHIF branch

  2. Pay via MPesa paybill number

Follow the procedure below to make contribution via mpesa:

  1. Go to Safaricom menu and select MPESA.

  2. Choose the Pay Bill option.

  3. For the M-pesa NHIF Pay bill number (business number), enter 200222.

  4. Enter your contributor’s National Identity Card Number.

  5. Enter the amount to contribute.

  6. M-PESA asks for your M-PESA PIN. Enter your Mpesa PIN and hit OK.

  7. M-PESA gives you the confirmation screen. Carefully confirm that all the details are correct. Press OK to finish to pay NHIF via Mpesa.

  8. You will receive an M-PESA Transaction confirmation SMS!

How do I check my NHIF Statement?

With any type of mobile phone do the following:

  • Compose a new sms

  • Type the letters “ID”, a space, then your ID number (or passport number if applicable) e.g ID 12345678

  • Send to 21101

Note: Charge for this service is Kshs 10 only.

THE PROCEDURE:  

Step 1: Login to SapamaERP.com, Go to "Payroll" Menu > Click on "Payslips" Search for the month>Click "Download">Click"NHIF" report   


Step 2: Login to NHIF portal https://epayments.nhif.or.ke/selfservice/ and upload the by-product

Step 3: Generate payment slip for the NHIF just submitted

You need to generate a payment slip for the NHIF obligation. The payment slip is what you will use to make a payment for this liability at the bank.

Step 4: Pay the NHIF at any NHIF approved banks


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