Civil servants and other members of the National Hospital Insurance fund have been advised to update their records for improved service delivery.
The fund manager Kerugoya Alex Muthamia said those who are not registered members should take the initiative with the old members advised to update their records including their latest mobile numbers.
Muthamia said updating of the individual members records apart from making communication easy with the members also get rid of fraudsters.
“Every time somebody attempts to use your NHIF number, a message is sent to your mobile phone which alerts you of the same.
If such a member is not the one using the card, he or she will be able to alert the office and action taken to stop the misuse,” he said.
Muthamia said civil servants must also make sure they have an up to date record involving their next of kin.
He said there have occurred incidents where the principal member dies and the money cannot benefit his dependants since they are not in the list of his or her next of kin.
“The money after a long struggle is taken to the Public trustee, leaving the dependents frustrated and with nothing to make them move on,” he said.
He said public servants can liaise with their Human resource departments for the update of the next of kin record and avoid complicated situations in the event of the contributor’s death.
Muthamia made the remarks at Kerugoya hotel during a one day sensitisation, monitoring and evaluation of the comprehensive medical insurance scheme.
“Your dependants, those you have indicated as the beneficiaries of the insurance are not necessarily your next of kin,” he said.
Muthamia said a member is required to notify the fund on admission to a health facility between 24 to 48 hours.
“Late reporting result to complications unless is an emergency which is a mandatory service.
The notification is not meant to punish the patients but to control abuse of the cover which has been happening with contributors attempting to use the NHIF card for non members and non dependants,” he said.
He cited an incident where a contributor assisted a neighbour only for the kid to die resulting to huge complications and cutting out medical insurance for one of his dependants who was still living and in school.
“Every time the member tried to get medical assistance for the child, he would be repulsed as the records indicated the child had died,” he said.
The manager said the fund is offering rehabilitative services for those addicted with drugs and substance abuse.
The insurance cover 90 days of the rehabilitation and even for those who may relapse in the process, though relapsing is not encouraged.
Mwangi said many of the members are also not aware of the cover for the primary health care (IVF) for couples who are unable to conceive and get children.
He said there are special clinics in Nairobi and Eldoret where members with such complications are referred for assistance.
“Treatment by herbalist is not covered by the National Hospital Insurance Fund and members who choose to go that route will have to meet the cost on their own,’’ he said.
‘’Annual medical checkups is also provided for by the scheme though many of the public servants are not utilising the provision,’’ the manager said.
He said the Annual medical checkup is provided for to make sure the member remains health and early discovery of conditions.
Please go for the annual medical checkups and stop fearing the unknown, early detection of conditions will sometimes assist in reversing, preventing and in the control of the diseases.” he said.
He said the NHIF comprehensive cover caters for every health requirements and there should not be at any one time a member is supposed to pay cash money to any health facility.
‘If you pay any money the fund will not refund back that kind of money, if the facility is not able to offer the services you require, they should refer you to another facility,’ Muthamia said.
Members had complained that some health providers require some members to give additional money on top of what is offered by NHIF.
NHIF has also increased the number of children beneficiaries from the previous three to five less than 18 years and 25 years if they are still in school.
Those with more than five children will have to cater for the additional premiums of shs 3000 per year per child.
KNA by Irungu Mwangi