NHIF medical cover details

The National Health Insurance Fund (NHIF) is underperforming and unable to meet its obligations.

A report by the Auditor General, Nancy Gathungu says NHIF is broke, and on a downward with  a funding gap of over Sh3.6 billion.

“The fund’s performance is on a downward trend and if strategies are not in place to reverse the trend, the fund is likely to experience financial difficulties in future,” Gathungu warned.

According to the report NHIF’s  performance has dropped compared with the financial year 2017-18 when it earned an extra Sh295 million.

NHIF attributes the financial woes to millions of dormant accounts where members have failed to renew their membership with only 5.1 million  out of the registered 10.4 million being active.

Misuse of Funds

The audit also points out areas of mismanagement of funds as the case where Sh1.4 billion was paid for the drawings and design of a proposed resource centre in Karen, which is yet to take off 15 years later due to a land row.

There is also Sh3 billion that had been allocated for the construction of a multi-storey car park operated by NHIF, a cost that was 337 per cent increase from the initial cost of Sh909 million.

Raw Deal

NHIF has been giving members a raw deal when it comes to accessing quality HealthCare and most of the times patients are left to contend with understaffed and un equipped NHIF accredited medical facilities.

The facilities hardly have good medication and in most cases patients are forced to go buy quality medication in other pharmacies, which often leaves many members wondering why they need to pay the monthly charges to NHIF when it’s not meeting its obligations.

NHIF members in the formal sector even get a rawer deal as they have to pay more for the monthly premiums while NHIF only pays for bed charges in the event that they are admitted in a private hospital.