The National Government through the Director of Public Communication at the State House, Gerald Bitok, on Monday, June 17, addressed public concerns that pregnant mothers would have a 48-hour coverage limit under the Social Health Insurance Fund (SHIF).
Additionally, media reports had indicated the 48-hour limit was for normal delivery with caesarean delivery having a 72-hour window.
While admitting the presence of the limits, Bitok revealed that it did not necessarily mean the patients would not have their hospital bills cleared by the government.
“After 48/72 Hours Mother Transitions to Inpatient cover if and when the health situation of the mother or child requires,” he clarified.
The government further defends SHIF remittances for deliveries and noted that it was way higher than what was being offered under the now-being phased-out National Health Insurance Fund (NHIF) and Linda Mama Programme.
Under NHIF, remittances were Ksh10,000 and Ksh30,000 for normal and caesarean deliveries respectively.
The amount has now been raised to Ksh11,200 and Ksh32,600 for normal and caesarean deliveries respectively.
It should be noted that under NHIF, Kenyans contributed a minimum of Ksh500 monthly and the amount has now been adjusted to a 2.75 per cent gross salary deduction under SHIF.
On whether mothers with complications beyond the coverage limit would need to undergo fresh vetting before accessing SHIF, the government clarified, “In case of complications or reasons to stay longer, the provider will seamlessly transition the patient to inpatient cover and alert Social Health Authority (SHA).”
Bitok further stated that SHA would conclusively cover Antenatal Care visits contrary to media reports.
Another change in SHA is a daily cap for tariff for medical inpatient services at between Ksh3,500 to Ksh5,000 depending on the hospital.
This is limited to 50 days per household which the government defended stating that it was based on data on average admissions rates.
