Edu Afya NHIF Medical Scheme for Students: Requirements, How to Register, Benefits
The Ministry of Education signed a contract with NHIF to provide medical insurance for all Public Secondary School Students for the duration of their Study.
Who is eligible†
Any Student who is in a Public Secondary school. Registered by NHIF through NEMIS database.
Only the Student shall be covered.
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How to Register
Register the Student on Nemis Database.
The data shall be shared by Ministry of education to NHIF for registration. The student shall be physically present during bio-metric registration.
Note: Dependent /’Parents shall not be covered.
Benefits Package
| WHAT IS COVERED | |
| Out-patient General Out-patient Services:
Outpatient services provided by or on the order of a |
|
| clinician/ physician who is licensed as a general practitioner.
Specialized Out-patient Services: Outpatient services provided by or on the order of a physician who is licensed as a specialist or consultant and to whom a Member has been referred to by a general practitioner/Primary Care clinician where a member was registered.
• This caters for all routine outpatient services as per Kenya essential package for health subject to policy terms and conditions. • Referral for specialized services which includes the following: • Drug and Substance Abuse Rehabilitation Services • Renal services and dialysis • Specialized radiological diagnostic services • Chronic ailment services such Diabetes and Hypertension, Ultrasound, ECG, • Cancer medical care and treatment services which includes radiotherapy services, chemotherapy services or surgical intervention subject to preauthorization by the fund. |
|
| Dental Cover | This benefit caters for outpatient dental procedures, which include but not limited to:
• Extraction. • Root canal. • Dental X-ray Services. • Accident related inpatient Dental cases will be covered under the standard inpatient surgical benefits to the full inpatient limit. |
| Optical Cover | This benefit caters for expenses relate to eye treatment, including the cost of:
• Consultation. • Eye testing. • Prescription for ophthalmic treatment and prescription of eye glasses. • Accident related inpatient optical cases will be covered under the standard inpatient benefits to the full inpatient limit. |
| Last Expense/ Group Life | This shall be paid to the declared dependents next of kin upon demise of a student. |
| Nature of Service | WHAT IS COVERED |
| Inpatient | Inpatient shall be on a referral basis from the selected outpatient Health Care Provider. This cover includes medical and surgical conditions which require admission.
It includes the following: • Hospital accommodation charges • Pre-hospitalization diagnostic services • Doctor’s (physician, surgeon & anesthetist) fees. • Nursing charges • Drugs/medicines, dressings and internal surgical appliances. • Diagnostic, laboratory or other medically necessary services • Rehabilitation services • Operating theater services • Radiological diagnostic e.g. x-ray services, CT scan, MRI, ECG • In-patient physiotherapy. Day care surgery surgical procedures that do not require overnight stay. |
| Emergency
Road Rescue |
Emergency Road RescueAmbulance services for transportation and transfer of a sick member for treatment from a place of incident or facilities where adequate care is not available to the next available NHIF accredited hospital or medical facility within the territorial limits of Kenya. |
| Emergency
Air Rescue |
Emergency Air Rescue Services will be provided for transportation and transfer of an injured member to an NHIF accredited facility within the territorial limits of Kenya where adequate medical care is available. |
| Overseas Treatment | Treatment costs arising from a condition that warrants treatment overseas because the treatment is not available in Kenya will be covered subject to preauthorization from NHIF. |
For more information, contact us:
THE NEAREST MINISTRY OF EDUCATION OFFICE.
NATIONAL HOSPITAL INSURANCE FUND
P .0. Box 30443 – 00100, Nairobi, Kenya
Tel: 272 3246, 271 4793/94, 272 2527.
Toll Free: 0800 720601
Complaints direct line: 271 0335
Fax: 020 2714806
SMS: 21101