MPs Push for SHIF Review

Members of Parliament have called for timely annual reviews of the various cover limits under the Social Health Insurance Fund (SHIF) to ensure patients receive adequate medical services.

Legislators raised concerns over the capping of medical services, particularly for renal and dental care, arguing that the limits are insufficient compared to the actual costs incurred at different medical facilities.

Medical Services Principal Secretary Harry Kimutai revealed that the capping for optical services is set at Sh1,000 per family per year, with eligibility restricted to children under 18 years.

For oral health services, the limit is Sh2,000, while essential outpatient services—including laboratory investigations, imaging, prescription medication, vaccinations, management of mental health conditions, wellness programs, and counseling—are capped at Sh900 per beneficiary.

The cover also provides for Sh10,000 for normal delivery and essential newborn care, Sh30,000 for Caesarean section and essential newborn care, and Sh10,650 per week for renal care therapies such as haemodialysis.

Peritoneal dialysis is covered at Sh85,200 per month, with members required to top up any excess amounts beyond the cover limit.

The legislators emphasized the need for transparency and fairness in determining medical service limits and the selection of overseas treatment facilities to ensure Kenyans receive the best possible healthcare options.