Patients under the National Hospital Insurance Fund(NHIF) are advised to tie tightly their laces, the walk is about to get rocky.
The fund has proposed to reduce payout of crucial benefits in an attempt to cost cut.
Among the sensitive benefits targeted are renal dialysis, major surgeries and diagnostic tests such as MRI and CT-scans.
NHIF, in the new plan, will only pay an average of Ksh 6,000 for renal dialysis, and Ksh 9,000 for MRI scan, down from the current Ksh 95,00 and Ksh 15,000 per session, respectively.
CT-scan patients will have to pull up their socks, to afford Ksh 2000 on top of the current Ksh 6,000.
As seen by Business Daily, NHIF, in their new proposal, seek to reduce costs by at least Ksh 2.9 billion, by the time it’s June 2022.
It further seeks to cut weekly costs incurred on kidney patients by Ksh 1 billion annually to Ksh 2.7 billion.
The fund is proposing to cut the average payout to minor surgeries from Ksh 26, 215 to Ksh 22,000. concurrently, major surgeries fee will be reduced from Ksh 80,266 to Ksh 70,000.
NHIF hopes to lower the average claim for outpatient services from Ksh 12,412 to Ksh 10,890.
On the upside, the fund is to increase benefits for cancer patients, amid a hike in the case numbers.
The average fee for a PET scan will reportedly increase to Ksh 40,000 from the present Ksh 32,320.
Fees for chemotherapy will be increased from the current Ksh 17,062 to Ksh 25,000.
Additionally, NHIF seeks to increase the fee paid out for complex chemotherapy from Ksh 72,582 to Ksh 100,000.
The average radiotherapy claim will be Ksh 72,000,from the present Ksh 61,224.
The Kidney Pain
The proposal came days after the Fund announced an increase in the kidney cases in the country had pushed the amount of claims it paid for patients higher, raising the renal dialysis payments by three times, in the past four years.
In their yearly calendar for June 2021, the Fund said it paid Ksh 3.844 billion for 295,563 patient claims.
The amount marks a 208% jump from the Ksh 1.267 billion the state-owned insurer paid in a similar period in 2017.