Principal Secretary for Medical Services, Harry Kimtai, has announced that the Ministry of Health is in the process of forming a committee to review the tariffs and benefits under the Social Health Authority (SHA).
In a statement, Kimtai explained that the committee will be tasked with reviewing the current framework, offering practical solutions, and making informed recommendations based on stakeholder feedback.
“The committee’s report will provide both short- and long-term measures to ensure the sustainability of SHA and its responsiveness to the needs of Kenyans,” he said.
In the meantime, Kimtai encouraged Kenyans to enrol in SHA, while urging informal sector members to undertake means testing and remit their premiums to maintain service delivery. He also called on employers to ensure their employees are registered with SHA and that monthly premiums are submitted promptly.
Additionally, the government is exploring strategies to enhance the overall healthcare delivery system, including the potential recapitalisation of the Kenya Medical Supplies Authority (KEMSA) to improve the availability of essential medical supplies in healthcare facilities.
“This initiative will complement SHA’s efforts to ensure continuous access to critical healthcare services,” Kimtai noted.
He advised beneficiaries and stakeholders to refer to official SHA platforms for accurate information regarding benefits, tariffs, and access rules. For further inquiries, he directed individuals to contact 147 or email customerservice@sha.go.ke.
Kimtai highlighted that SHA’s tariffs are designed to ensure sustainable healthcare coverage and equitable access through a shared responsibility model. He clarified that in cases where hospital charges exceed the set limits, beneficiaries may be required to make co-payments.
He also outlined that SHA covers admissions for Intensive Care Units (ICU) and High Dependency Units (HDU), with provider payment mechanisms based on per diem rates, which vary by facility type:
- Level 4: KSh 3,360 per day
- Level 5: KSh 3,920 per day
- Level 6: KSh 4,480 per day
Each household is limited to 180 days of coverage per year, and services can only be accessed at empanelled and contracted Level 4-6 facilities.
“Members are required to top up any costs exceeding the cover limit (co-payment). The cover limits apply uniformly across Public, Faith-Based, and Private facilities,” Kimtai explained.
