No person with any form of disability, will ever suffer out of pocket expenditure to procure assistive devices, the Ministry of Health said as it hit the road to popularise a set of new benefit packages for Kenyans under the Social Health Authority (SHA).
This equally applies to patients seeking pharmaceutical refills and dental services among an array of new benefits covered in the new health scheme.
Health Cabinet Secretary Susan Nakhumicha said the government will pay for assistive devices needed by persons with disability, to enable them continue with their normal daily life.
“Assistive devices such as hearing aids and spectacles will be covered under the primary cover of the SHA,” said the CS when she engaged journalists on Monday evening and yesterday morning, noting that unlike under the defunct National Health Insurance Fund (NHIF) which required a person to have an enhanced cover.
Operational on July 1
While outlining a number of new benefits that Kenyans should expect immediately the SHA becomes operational on July 1, just 11 days away, the CS said patients with chronic illnesses such as diabetes would also have an allowance for refills from listed community pharmacies.
“The beauty of this new scheme is that no Kenyan with a disability will pay for assistive devices. This is a new benefit package cost by a team of economic specialists after looking closely at the health services Kenyans have been seeking for,” said the CS.
She said the government will provide assistive devices to support patients with permanent physical and/or sensory disabilities and progressive chronic conditions such as Parkinson’s disease and multiple sclerosis.
However, she cautioned that medical devices will only be issued to persons with permanent disability recognized by the National Council for Persons with Disability (NCPD). Under this arrangement, there will be one 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.
Temporary inability
The devices required due to temporary inability or immobility will be factored in the surgical package.
After a team of experts cost the 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 Sh60,000 and Sh100,000 depending on the outlet.
A pair of crutches will cost about Sh900, while clubfoot brace will go for Sh1,000, and walking frames will be bought at Sh500 and therapeutic footwear at Sh1,000.
Nakhumicha said the patients who are required to always have drugs with prescriptions can be able to refill them from specified pharmacies under the new cover.
“If you have a chronic illness prescription, 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, announcing that registration for Kenyans under the SHA will kick off this Friday countrywide.
Similarly, from July 1, Kenyans seeking dental services will be covered under the new scheme, which were not initially covered by NHIF unless through the enhanced cover.
The CS also pointed out that households can access an end-of-life cover which will cater for services such as mortuary fees under the cover.
“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 Whatsapp fundraisers that Kenyans have to endure almost on a daily basis.
The other benefits at the disposal of Kenyans from July 1 include; Accident and Emergency. “We are saying that with this new scheme, if you are a Good Samaritan, and you are at the accident scene, you shouldn’t worry, but help the injured to get to hospital, and the government will pay for everything so long as the patient is registered,” she said.
Her sentiments were echoed by Medical Services Principal Secretary, Harry Kimtai who said NHIF had so many gaps in access to care, which the Kenya Kwanza administration found wisdom in reforming.
“We realised that we cannot go far with NHIf under the Kenya Kwanza Government plan. This is why we took a 360 degree turn, and we worked on bringing reforms,” said Kimtai. The reforms he said facilitated the establishment of four bills, now Acts to enhance reforms in the health sector.
The Acts are Social Health Insurance Act, Public Healthcare Act, Digital Health Act and Finance Insurance Fund Act.
“We are progressing very well, and the benefit package is what is actually new. This is what the Mwananchi is going to get,” he said.
He noted that with the NHIF, there was no equity, and was discriminative, meaning that payments to the Fund were done differently, with those who have high income paying a higher proportion.
“The new scheme is not discriminatory. What we did is standardise the payments; the salaried and unsalaried, will both contribute 2.75 percent to access medical services,” he said.
He highlighted that Mental Wellness is another benefit in the new scheme that was not covered in the defunct NHIF. This one, Kimtai said, will also be covered under the new program allowing Kenyans to have screening for mental health illnesses.
“Kenyans wait for a person to be sick, and then go for check up, and eventual treatment. But for this scheme, Kenyans will be covered,” he said.
