NHIF paid Sh1. 8 billion for kidney treatment

By M&M Reporter

The National Hospital Insurance Fund (NHIF) spent Sh1.76 billion in the 2017/2018 financial year towards  treatment for kidney renal dialysis failure, up from Sh1.24 billion spent in the 2016/2017 financial year.

In the last half of the 2018/2019 financial year, NHIF paid Sh64. 7 million towards treatment for Kidney transplants, up from Sh21.7 million spent in the previous year.

The top expenditure per health care benefit package utilization report released by the national health insurance provider reveals that in the last half of 2018, Sh922.8 million was paid for 73,757 kidney dialysis sessions, with Nairobi County being the highest beneficiary.

According to the report, Kidney renal dialysis is covered per family, and is applicable to inpatient and outpatient care for pre-dialysis, intra dialysis and dialysis care under the Renal Dialysis and Kidney Transplant Package.

Under the package, NHIF pays up to a maximum of Sh500,000 for a kidney transplant, for both local and overseas transplant for national scheme members. The package covers pre-transplant, intra-transplant session and immediate post-transplant inpatient care. Overseas claims payments are made to the treating facility, subject to meeting overseas claims requirements.

The requirements for overseas treatment include referral by a certified nephrologist/urologist, evidence of an identified matching kidney donor, letter of no objection by the Director of Medical Services, Quotation of the cost of care by the overseas care provider, and evidence of scheduled transplant care plan.

Other requirements include letter of exclusivity from the Local Overseas Care Manager, and evidence of ability by the member to meet extra treatment costs, including travel insurance and overseas stay.

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