The Ministry of Health has revealed hearing aids and other assistive devices will be covered in the new benefits package as the government seek to popularize the transition from National Health Insurance Fund (NHIF) to Social Health Authority (SHA).
Health Cabinet Secretary, Susan Nakhumicha, said the government will pay for assistive devices needed by persons with disability, to enable them continue with their daily life without suffering out of pocket expenditure.
“Assistive devices such as clutches and walking frames will be covered under the Primary Healthcare cover of the SHA,” the CS said when she spoke to journalists at a Nairobi Hotel.
“The beauty of this new scheme is that no Kenyan with disability will pay for assistive devices. This is a new benefit package designed by a team of economic specialists after looking closely at the health services Kenyans have been seeking for,” the CS added.
She stated that the government will provide assistive devices to support patients with permanent physical and/or sensory disabilities and progressive chronic conditions.
However, she cautioned that the medical devices will only be issued to persons with permanent disability recognized by the National Council for Persons with Disability (NCPD).
Under this arrangement, beneficiaries will receive one assistive device per household per year, except for therapeutic footwear, which has a limit of two per household per year.
“Hearing Aids are limited to individuals aged 18 years and below and will only be issued once per lifetime,” she said adding that devices required due to temporary inability or immobility while factored in the surgical package.
After a team of experts estimated the cost of benefits, a process that took a year and a half, the new cost of hearing aids will be at Sh55 000 compared to the current one, which ranges between Sh. 60 000 and Sh. 100, 000 depending on the outlet.
A pair of crutches will cost about Sh. 900, while clubfoot braces will go for Sh1 000, walking frames will be bought at Sh500 and therapeutic footwear at Sh1000.
While outlining other new benefits that Kenyans should expect immediately the SHA becomes operational on July 1, Nakhumicha said patients with chronic illnesses such as diabetes would also have an allowance for refills from listed community pharmacies.
Nakhumicha explained that the patients who are required to always have drugs with prescriptions will be able to refill them from specified pharmacies under the new cover.
“If you have a chronic illness prescription for example a patient of diabetes who takes their medication throughout, instead of going back to the specialist, and you have a prescription, you can go to a listed community pharmacy and receive a refill,” the CS said.
The CS also pointed out that households will be able to access end-of-life benefits which will cater for services such as mortuary fees.
“The end-of-life cover is meant to assist Kenyans in alleviating the burden of send-offs for their family members,” she said, noting that this will reduce the many online fundraisers that Kenyans have to bear frequently.
The CS noted that one of the other benefits at the disposal of Kenyans from July 1 include; Accident and Emergency cover.
“We are saying that with this new scheme, if you are a Good Samaritan and you are at the scene of an accident, you shouldn’t worry, help the injured to get to hospital; the government will pay for everything so long as the patient is registered,” she said.
Nakhumicha’s assertions were echoed by Medical Services Principal Secretary, Harry Kimtai said NHIF had so many gaps in access to care, which necessitated the reforms.
“We realised that we cannot go far with NHIF under the Kenya Kwanza Government plan which is why we took a 360 degree turn and worked on bringing reforms,” said Kimtai.
The reforms, Kimtai said, facilitated the establishment of four bills, now Acts, to enhance the health sector.
Digital Health Act which provides for the establishment of the Digital Health Agency that will guide the provision of digital health services and establishes a comprehensive integrated digital health information system (digital superhighway).
Facility Improvement Financing Act which establishes a framework for the retention and use of health resources at the source.
“We are progressing very well and the benefits package actually has new added benefits. This is what the Kenyans are going to get,” he said.
“The new cover, for instance, also includes dental and optical services among other new benefits not previously included in NHIF,” he added
He emphasized that Mental Wellness is another added benefit in the new scheme that was not covered in the defunct NHIF saying the new program allows Kenyans to have screening for mental health illnesses.
“Kenyans wait for a person to be sick, and then go for checkup, and eventual treatment. But for this scheme screening will be covered,” he said.
Under the wellness package, the government will also undertake screening for chronic illnesses such as diabetes and hypertension to facilitate early detection.
The other benefits are; the specialized essential diagnostics, screening for common diseases and cancers that were also not there under the NHIF.
He further noted that with the NHIF, there was no equity and it was discriminative, meaning that payments to the Fund were done differently, with those who have low income paying a higher percentage of their income.
“The new scheme is not discriminatory, what we did is standardize the payments; the salaried and unsalaried, will both contribute 2.75 percent of their income to access medical services,” he said.
Kimtai explained to the press why moving from NHIF to SHA is important, clarifying that all the figures in the costing of commodities and services are based on the costs calculated carefully by the team.
However, despite the new benefits listed, they may be suspended once a Kenyan fail to remit their required amount to the Authority and the suspension will only be lifted once an individual resumes their payments.
Health Ag. Director General Dr. Patrick Amoth underscored the government’s commitment towards attaining Universal Health Coverage (UHC) through the ongoing reforms.
“Political goodwill is important for the achievement of UHC, which President William Ruto has demonstrated, this is why we are here discussing the journey towards UHC,” said Amoth.
He noted that UHC is based on the needs of the population to be served and is actualized by strengthening healthcare services that resonate with the system of governance.
By Purity Mugo
