November 2017 Standardmedia; Senior security officers are the biggest winners in the new National Hospital Insurance Fund’s (NHIF) comprehensive medical cover.
The National Police Service (NPS) and the Kenya Prisons Service reverted to NHIF but with revised terms that suits the medical needs of more than 150,000 officers after failing to renew their contract with their former insurer, AoN.
AON Chief Executive Officer Sammy Muthui said the contract ended at midnight on September 30 this year.
The new medical cover allows outpatient and inpatient treatment without limits or ceilings in Government, faith-based or some private hospitals for some officers in job groups A-L, PG 1-7 (NPS) and PG 1-8 (Prisons).
“Both inpatients and outpatient limits and ceilings in high-cost private hospitals for officers in job groups M-T, PG 8-15 (NPS), PG 9-15 (Prisons) and their eligible dependents shall apply,” reads a section of the cover.
The medical cover will cater for the principal member, spouse and five declared children of up to 21 years of age or a maximum of 25 years if still in full-time formal education with no age limit for dependants living with disability.
The members and their eligible dependants will access outpatient, inpatient and specialised medical services in NHIF-recognised facilities across the country.
The scheme shall cater for treatment outside the country for medical conditions whose treatment is not available in Kenya.
All costs in terms of medical expenses, travel costs and stay outside the hospital for the patient (member or dependant) and the person accompanying them shall be covered subject to pre-authorisation by NHIF.
NHIF shall also meet foreign travel and accommodation costs for a patient’s organ donor.
The insurer shall reimburse expenses arising while a member is abroad on official duty and requires emergency treatment for an illness or injury that occurs during the period of travel.