NEW NHIF REGULATIONS



● The new NHIF regulations limit cover to a maximum of one spouse and five children.
● New members will now have to wait for 90 days before they start accessing services or benefits in addition to making a one year upfront payment within the waiting period.
● Late payment will attract a fine of 50% of the monthly contribution coupled with a requirement to pay for one year in advance. They will also be restricted against claiming benefits for a period of 30 days.
● Defaulting for 12 months and above will force one to start payment afresh and can only be eligible for benefits after 90 days upon resumption of payment. A one year upfront payment will be applied and strict adherence to deadlines.
access to specialized services shall be restricted to a six-month waiting period following card maturity for new members.
● Access to maternity benefit will henceforth be restricted to 6-months post card maturity for principal members or spouse declared at the point of registration.
● For both maternity and specialised services, any dependent declared after initial registration shall be subjected to a 6-month waiting period.
● For medical inpatient and medical outpatient additional dependents shall be eligible for benefit after 30 days waiting period. This waiting period of 30 days will also apply in case of change of spouse.
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