People searching for NHIF hospitals in Kenya now need to check whether their preferred hospital or clinic participates in the Social Health Authority (SHA) system. The old NHIF categories and historical contracted-hospital lists do not establish today’s provider status.
How to check a healthcare facility
- Begin at SHA’s official website for current scheme information.
- Ask the hospital whether it is currently empanelled and contracted for the specific SHA service you need.
- For a facility’s contract reference, the SHA contract verification portal can verify a contract where you have its reference or QR code.
- Confirm the benefit package and any required approval before planned treatment.
- Call SHA customer care at 147 if the facility’s status is unclear.
Accreditation, empanelment and contracting
A licensed healthcare facility is not automatically guaranteed to offer every SHA-funded service. The Social Health Insurance framework includes provider accreditation, empanelment and contracting. Ask about the exact service and whether it can be billed under the relevant fund.
Public and private hospitals
Healthcare services can involve public, private and faith-based providers, subject to applicable rules and contracts. Coverage may vary by treatment type, referral pathway and eligibility.
What to ask before treatment
- Is this specific procedure or treatment included in the applicable SHA benefit package?
- Does the facility have a current contract for this service?
- Is a referral or prior authorisation required?
- Are there additional charges not paid by the scheme?
- What documentation should I bring?
Emergency care
For a medical emergency, seek urgent care promptly. Do not delay emergency treatment while attempting to verify an online facility list.
Why old NHIF lists are unreliable
NHIF-era hospital classifications and contracting arrangements changed with the transition to SHA. A hospital appearing on an older list should not be assumed currently contracted or covered for a particular service.
