3.77 Million NHIF Defaulters to Lose Medical Services

3.77 million National Hospital Insurance Fund (NHIF) members will no longer get services in government and private hospitals after defaulting on monthly contributions.

The latest NHIF data for the financial year ending June 2022 shows that the number of defaulters rose to 8.8 million from 5.03 million in a similar period in 2021.

This made the State-operated medical insurer to miss its Sh90.57 billion targeted premium collections for the review period.

The increase in defaulters came a time when companies were laying off workers amid an economic crisis occasioned by the coronavirus pandemic.
 
“The target was not achieved due to macro-economic factors in the country which caused companies to downsize, reduce salaries and some to close,” the report said.

“The informal sector has also faced financial challenges caused by the poor economic conditions thus making it difficult for members of this sector to make their voluntary contributions to the fund and adverse selection.”

Policyholders who default on NHIF monthly contributions are usually denies access to services unless they pay.

The insurer gives members a grace period to re-activate their accounts but they have to wait for three months to enjoy the cover.

NHIF said Sh3.8 billion in cancer treatment was paid for more than 47,000 beneficiaries in the last financial year.