Kenya Introduces Social Health Fund for Overseas Treatment, with Stringent Guidelines

The recently implemented Social Health Insurance Fund ensures that Kenyans can still receive medical treatment abroad, as long as they meet certain requirements.

Health Cabinet Secretary Susan Nakhumicha has announced a series of guidelines stating that the Insurance Fund will partner with international healthcare facilities to aid Kenyans dealing with health crises. Nevertheless, those seeking medical assistance through the Fund must first guarantee that their contributions are current. In addition, they must furnish proof that the required treatment is unavailable within Kenya.

Beneficiaries are permitted to seek treatment outside of Kenya as long as it is offered by a healthcare provider or facility that is contracted by the regulations. To secure approval from the Social Health Authority, which comprises Francis Atwoli and Dr Patrick Amoth, beneficiaries need to fill out a specific form as described in the Medical Practitioners and Dentists Act. Additionally, patients must submit a referral for overseas treatment from their attending doctor or specialist through the designated online procedure.

The Claims Management Office will commence with an examination of all information submitted, concentrating particularly on the signature of the treating doctor or consultant, in order to determine the request's legitimacy. The goal is to establish whether the requested healthcare is unavailable in our country. In addition, the Office will investigate if the healthcare provider is officially registered with the Authority, and if the requisite funds are within the insured patient's package boundary.

As a rule, Kenyans opt to go abroad for dedicated medical care such as cancer and heart-related diseases. The go-to destinations are mostly India and the UK. Without replacing the National Health Insurance Fund (NHIF), this newly introduced insurance fund aims will provide the populace with top-quality medical attention that they can access with ease.