Gharama ya Vifurushi Vipya vya Bima ya Afya NHIF 2023
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About National Health Insurance Fund (NHIF)
The National Health Insurance Fund (NHIF) is a Social Health Insurance Institution established under the National Health Insurance Act, Cap 395 with the main objective of ensuring accessibility of health care services to people. It is a Government entity that operates under the Ministry of Health (MOH).
What is Health Insurance?
The purpose of purchasing health insurance is to have financial protection against the high expense of medical care. A wide variety of sicknesses and conditions are covered by the several kinds of health insurance coverage. You have the option of purchasing either a general health insurance coverage or one that is tailored to cover a particular ailment. In most cases, the costs of medical care, hospitalization, and medication are covered by the premium that is paid toward a health insurance coverage.
Gharama ya Vifurushi Vipya vya Bima ya Afya NHIF
According to the NHIF, the individual costs Sh 192,000 (I Care Health), Sh 384,000 (Invest Health), and Sh 516,000 for new Packages for those aged 18 to 35. (Fulfill Health).
Individual packages for people aged 39 to 59 cost Shs. 240,000 (I Care for Health), Shs. 440,000 (Invest in Health), and Shs. 612,000. (Fulfill Health).
I Care for Health costs Shs 336,000, Invest in Health costs Shs 660,000, and Shs 984,000 per person are the rates for those over 60. (Fulfill Health).
Here are NHIF Packages Benefits
1. Consultation – This covers for costs related to Consultations.
2. Medicines and medical supplies – The Fund covers for the costs relating to medicines prescribed in Generic names and medical consumables as per the National Essential Medicines List (NEMLIT) and additional medicine list recommended (to NHIF) by experts and stakeholders.
3. Investigations – The Fund covers for the costs of Investigations and Diagnostic tests as per the Investigation List in the benefits package. There are 321 Investigations including Ultrasound, Echocardiography, CT-Scan, MRI and Ultrasound.
4. Surgical Services – Includes Minor, Major and Specialized surgical services performed from Health centres to Referral level hospitals.
5. Inpatient Care Services including ICU and HDU – The Fund covers for the daily admission costs depending on the level of the facility and the agreed daily rates as per the Fee Schedule, Investigations, Medicines and Medical Consumables dispensed while the member is admitted.
6. Physiotherapy and rehabilitation services – This is provided to inpatients and outpatients where the facility has specialists for the related services.
7. Eye and Optical Services – NHIF covers the costs for optical services to all beneficiaries. ( Treatment of Eye diseases and refraction for visual defects.
8. Spectacles – The Fund also pays for visual corrective spectacles to the principle member (one pair for a period of 3 years).
9. Dental and Oral health Services – This is provided to inpatients and outpatients where the facility has specialists for the same. This includes dental conservation surgeries (Carries and dental filling), gum diseases, dental extractions, root canal treatment, Orthodontics and denture
10. Retirees Health Benefits – Comprehensive Medical Services are offered to the Retired principle members and their spouses, for their entire lives.
11. Medical/Orthopaedic Appliances – The Fund provides supportive orthopaedic and medical appliances including White Cane for blind people, Neck and Thoracic Spine Collars, Hearing Aids, Lumbar Cossets and Braces, Walking Crutches and leg orthopaedic Supports, (ankle, knee and above knee orthopaedic supports).
The benefit package contains a wide range of Outpatient and Inpatient Services. These services include 354 Investigations, 51 Ordinary Procedures,52 Specialized Procedures, 94 Minor Surgeries, 210 Major Surgeries, 148 Super Specialized Surgeries,16 Medical and Orthopaedic appliances, 522 types of Medicines, 40 Cancer Medicines, 17 Immunosuppressant and Immunostimulants and 40 Medical Supplies.
These are services that are offered through a special permit, these include:
- Cancer chemotherapy for cancer patients
- Immunosuppressant medicines for patients, who have organ transplants,
- Haemodialysis and erythropoietin for patients with renal failure,
- Reading glasses and special radiological imaging such as CT scan and MRI
- Medical and Orthopaedic appliances
- Complex Implants
- Advanced Cardiac Services
- Some selected Medicines
- EMG needle
- Orthodontic Services
- Radiotherapy services
Fomu ya Usajili Wanachama wa Vifurushi NHIF
NHIF has established offices in all regions in Tanzania Mainland and Zanzibar to bring its services closer to members and the general public. Each regional office is managed by a Regional Manager and contacts of offices can be seen through this link.