Linda Mama to be restored as Health ministry releases new SHIF tariffs

The Ministry of Health has released new tariffs for the benefits package in the new Social Health Insurance Act (SHIA) medical scheme.

Health Cabinet Secretary Dr. Deborah Barasa has confirmed that the Linda Mama programme for expectant mothers will be incorporated and enhanced to sustain the gains in reducing maternal mortality rates in Kenya.

Cancer patients will get a cover of up to Ksh.400,000 for various oncological services.

Dr. Barasa spoke while leading stakeholders at the National Validation Forum for the new tariffs to the benefits package under the SHIA where they discussed strategies to attain quality and affordable healthcare for all.

“In response to the rising maternal mortality rate (MMR), we have prioritized financing for indigent pregnant mothers. Tariffs for normal deliveries have been increased to Ksh.10,000 and for C-sections to Ksh.30,000, ensuring comprehensive coverage for mothers and their families,” she said.

Under SHIF, patients with diabetes seeking outpatient services provided in Level 4 to 6 facilities will get a cover of up to Ksh.4,300, those dealing with hypertension Ksh.2,850, while those having sickle cell anaemia Ksh.6,800 per year.

Inpatient services in Level 4 to 6 hospitals, with a limit of admission of up to 180 days per household, shall charge a tariff of Ksh.3,360 in Level 4, Ksh.3,920 in Level 5, and Ksh.4,480 in Level 6.

Tariffs for the management of kidney failure in Level 3-6 facilities will range from Ksh.10,650 for hemodialysis and hemodiafiltration services per session and a Ksh.85,200 monthly fee for peritoneal dialysis.

Diagnosis, staging, and treatment of cancer have a limit of up to Ksh.400,000 for various oncological services ranging from chemo administration, PET scan, CT scan, MRI, radiotherapy, chemotherapy, and brachytherapy, among others.

“Two years after rollout, those who lose their loved ones will get a cover of Ksh.3,000 for embalming and Ksh.500 per day for storage of the body for 5 days before burial,” Dr. Barasa noted.

The Social Health Insurance Act (SHIA), alongside the Primary Health Care Act and Digital Health Act, had been declared unconstitutional by the High Court in July on grounds of, among others, lack of proper public participation.

A three-judge bench suspended the three acts for 120 days for the government to rectify the inherent illegalities.

CS Barasa expressed optimism that all was set for the rollout on the 1st of October this year.

“The comprehensive benefit package reflects extensive public participation and consultations with key stakeholders, including the public, employers, healthcare providers, county governments, the civil society, and Parliament,” she said.

On why registering was important, the SHA CEO said; “Both salaried and non-salaried Kenyans will make a monthly 2.75% contribution of their income to the fund.”