What does SHIF cover? Answers to Frequently Asked Questions
SHIFâKenyaâs Social Health Insurance Fundâhas become a frequent topic of discussion among employers, employees, and compliance officers. As new health insurance legislation replaces or supplements components of NHIF, many want clarity on coverage, obligations, and what records must be kept. This article answers the most common questions and outlines practical steps for employers and professionals. What Is SHIF? SHIF is established under the Social Health Insurance Act, 2023, with regulations published in 2024 to operationalize the scheme. It is managed by the Social Health Authority (SHA) and is intended to provide universal health insurance coverage in Kenya, reducing reliance on out-of-pocket payments. What Does SHIF Cover? While benefits may evolve over time, the current framework indicates that SHIF benefits will include: Outpatient care: consultations, general practitioner services, referrals Inpatient and hospitalisation services: ward stay, surgeries, intensive care (within approved network) Diagnostics, lab tests, and imaging: when prescribed by network providers

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