SUMMARIZED
Number of dependents per card to be limited to a maximum of one spouse and five children.
Members voluntarily joining the fund to wait for 90 days before they start accessing services or benefits. In addition to that, member to make a one year upfront payment within the waiting period.
A fine of 50% of the monthly contribution coupled with a requirement to pay for one year in advance for late payments.
Defaulting for 12 months and above will force one to start payment afresh and he/she can only be eligible for benefits after 90 days upon resumption of payment. A one year upfront payment will be applied and strict adherence to deadlines.
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.
Acess to specialized services to be restricted to a six-month waiting period following card maturity for new members.
Access to maternity benefit to be restricted to 6-months post card maturity for principal members or spouse declared at the point of registration.
NHIF says the new regulations which took effect on January 1, 2020 are aimed at attaining sustainable Universal Health Coverage.
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