The National Hospital Insurance Fund (NHIF) has reviewed its terms, now reducing the number of dependant children to five from the current 10, while eligible spouses will remain at one.
Additional dependents can be included subject to payment of additional premiums to be communicated after actuarial valuation.
In a Special Full Board Meeting held on December 17, 2019, nhif resolved that as from January 2020, the waiting period for new voluntary National Scheme members would be increased from current 60 days to 90 days and a one-year upfront payment introduced, payable within the waiting period.
The penalty on defaulting beneficiaries was retained at 50 percent of the monthly contribution for each month paid late, up to 11 months, coupled with requirement to pay for one year in advance and a restriction of 30 days before being eligible for benefits.
“In case of default for 12 months and above, the affected member will start payment afresh and be eligible for benefits after 90 days from the date of resumption of payment in addition to a one year upfront payment, payable within the waiting period while observing due dates,” said NHIF in a statement.
Also, Voluntary Members access to maternity benefit will be restricted to six months post card maturity for principal members or spouse declared at the point of registration.
“For both Maternity and Specialized Services, any dependent declared after initial registration shall be subjected to a 6-month waiting period after such declaration with exception of newborns who shall be considered eligible for benefit provided they are declared within 6 months from the date of birth,” adds the statement.
Medical inpatient and outpatient additional dependents shall be eligible for benefit after 30 days waiting period, which will also apply in case of change of spouse.
In the changes, access to specialized services shall be restricted to six-month waiting period following card maturity for new members, while for defaulters, there shall be payment of all penalties and one-year upfront payment of contributions coupled with a 30-day waiting period thereafter.