Monday, December 16, 2024 - The Government of President William Ruto has been forced to come clean on the benefits and tariffs under the Social Health Authority (SHA).
This is after members of the
public raised serious concerns about the medical cover and its benefits.
In a statement, the Ministry of
Health emphasised that the coverage of SHA is in line with gazetted tariffs as
stipulated by the law.
“The Ministry of
Health confirms that SHA's coverage is based on gazetted tariffs to the
benefits, published in November 2004. These tariffs ensure sustainable
healthcare coverage and equitable access while maintaining a shared
responsibility model,” the Ministry stated.
However, the Ministry noted that
in cases where hospital charges exceed specified limits, beneficiaries may be
required to make out-of-pocket expenditures.
“Regarding ICU and HDU services,
SHA provides for admissions in critical care units and high dependency units
(ICU and HDU). The provider payment mechanism (PPM) is a per diem rate, and the
rate depends on the type of facility visited,” the Ministry elaborated.
For level 4, patients will have
to pay Ksh3, 360 per day while those visiting level 5 will have to part with
Ksh3.900 per day as co-payments for HDUs.
Patients visiting level 6 will
be required to shoulder an extra Ksh4.480 per day. Each household has a limit
of 180 days per year for access rules. The Ministry however noted that
registered users can get services in level 4 - 6 facilities.
“Members can access service from
empanelled and contracted Level 4 to 6 facilities. The members will top up any
amount that exceeds the above cover limit (co-pay). The cover limit is the same
for public, faith-based, and private facilities,” SHA clarified.
The Ministry has committed to
removing barriers that may hinder access, ensuring beneficiaries face no
hurdles in obtaining the care they need.
The Kenyan DAILY POST
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