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Table 1 Health insurance schemes under the NHIF

From: Examining purchasing reforms towards universal health coverage by the National Hospital Insurance Fund in Kenya

Type of scheme

Premium contribution

Population covered

Civil servants schemea [13, 14]

Mandatory/automatic

Civil servants in the national and county governments, their declared spouse and up to 5 children of up to 21 years of age or 25 years if enrolled in fulltime formal education [13, 14]

County government schemea [15]

Mandatory/automatic

Employees of County governments that have contract arrangements with the NHIF, their declared spouse and up to 5 children of up to 21 years of age or 25 years if enrolled in fulltime formal education [16]

Parastatal/ private company schemesa [15]

Mandatory/automatic

Employees of parastatals or private firms that have contract arrangements with NHIF, their declared spouse and up to 5 children of up to 21 years of age or 25 years if enrolled in fulltime formal education [16]

National police and Kenya Prisonsa [17, 18]

Mandatory/automatic

Kenya Police Force, Administration police, officers in the Criminal Investigations Department, prisons and other security related officers, their declared spouse and up to 5 children up to 21 years of age or 25 years if enrolled in fulltime formal education [16]

Secondary schools’ scheme [EduAfya] [12, 19, 20]

Mandatory/automatic

All students in public secondary schools in Kenya

National scheme [21]

-Mandatory for formal sector workers,

-Voluntary for informal sector workers

Any person who is a resident of the republic of Kenya, who is self-employed or in the informal sector, their declared spouse (s) and children up to the age of 18 years

Health Insurance Subsidy for the Poor [HISP] Scheme [22]

Mandatory/automatic

Households with orphans and vulnerable children; poor elderly; and/ or persons, persons with disabilities and destitute families

Linda Mama Free maternity scheme [15]

Mandatory/automatic

All pregnant women who are Kenyan Citizens

  1. a The civil servants scheme, the national police and prisons service scheme, the county government schemes, and the parastatal/ private company schemes form the enhanced benefits schemes because they offer comprehensive medical insurance covers [16].