Social Health Authority Chairperson Dr Abdi Mohamed answers some Frequently Asked Questions about SHA.
Should I carry my old NHIF card when I go to the hospital?
You don’t need a card, you will use your national ID. That’s what you will register with (to SHA) and that’s what you will use.
Will I get all the services at my local facility?
You have an option to go to any of the following healthcare providers: Public, private, or Mission.
Is my nearest hospital well-equipped to provide all the services?
If a facility is not equipped enough to provide the services, you are allowed to go to the next facility that has the services you need. SHA does not limit you to one facility.
Can I lie about my income when registering for the Social Health Authority (SHA)?
You can’t lie because you will be asked questions that will determine your premium… You will answer some questions, and the system will triangulate what your premium is based on the answers that you have given.
How will I know how much hospitals in my primary care network charge for the services I am seeking?
For primary healthcare networks, you don’t need to know what they are charging, because there will be no co-payments in your primary care network. All you need is to register and go to the nearest Level 2 or Level 3 facility that is within your area. But for services that are beyond that, we have gazetted the prices and the benefits that you are entitled to. So, when you go to that facility for services, they will tell you what amount you are entitled to, and what they charge for the service.
What happens if someone falls sick and they are far from the selected facility?
You go to the nearest facility.
How will citizens file SHA complaints?
You raise the first complaint with the management at the branch level or the headquarters depending on where you are. If you are not satisfied with the answers or the way the issue has been addressed, then you can escalate it to the tribunal that has been set up to address complaints.
How often can I update my details on the system?
If you are employed, it’s not up to you to update, it’s for your Human Resources manager who will upload because this is a statutory deduction. For someone who is in the self-employed category, because you pay your premiums annually, you will be able to do a Proxy Means Testing (PMT) again to update your new premiums. PMT is a way of calculating what your premium is based on the answers that you have given.
What happens when you lose your job?
You move from the category of salaried individuals and into the category of non-salaried individuals. Under the non-salaried category, you will do a Proxy Means Testing (PMT) and it will give you premiums based on the results of the PMT.
-Transcribed by Yvonne Kawira
