NHIF, the National Hospital Insurance Fund, is a Kenyan government initiative that provides a layer of affordable health cover for Kenyan citizens at very reasonable cost. The team at Antara has immense admiration for the Kenyan government’s commitment to bettering the health of its citizens.
That’s why we’ve designed Antara’s coverage to work with, enhance, and maximize NHIF coverage as much as possible. We strongly recommend that all our members sign up for NHIF, and we also help with the sign-up process.
All that said, NHIF alone does not provide complete health coverage.
That’s where Antara comes in.
Antara's broad coverage and Health Navigation service pairs perfectly with NHIF to deliver effective care and better financial protection from health-related costs.
Why Do I Need Antara If I Already Have NHIF?
Because with NHIF alone, there are large gaps in what is covered. As a result, you’re not well enough protected from health risk. Antara's coverage fills in those gaps.
Also, NHIF can be hard to understand. It’s not easy for someone without training and experience to get the most out of what NHIF offers.
Finally, Antara offers a whole new kind of care that no one else, NHIF included, is offering. Our Health Navigation service brings care to you whenever you need it:
- Before you get sick with preventative care and screening
- When you’re not feeling well with virtual care option that will save you trips to the clinic
- At the clinic and hospital, to provide you a better experience
- When you come home from the clinic, to get you all-the-way better
And the results support our claims: Antara’s Health Navigation and Coverage Plans combined with NHIF, deliver better health outcomes. Antara members are healthier, happier, more productive, and better protected from health-related costs.
The Antara Difference: How we make NHIF better
- Complete Coverage: Antara coverage offers no hidden costs such as copays, deductibles, or out of pocket payments.
- Consistency Of Care: With Antara, there are no medication outages and care is the same across all accredited facilities. You’ll be covered for the same services at every facility.
- Transparency: With Antara you’ll understand how your care works. And we’ll be there to make sure you get the most value out of your coverage with us.
- NHIF Maximization: Antara Health Navigators are trained to get the most out of NHIF’s coverage as a complement to our service. We understand how to better navigate NHIF’s coverage rules so you can get everything to which you’re entitled. With Antara you’ll never have to worry about how and when to use NHIF - we do that for you!
- Less Time-Consuming: NHIF is a large bureaucracy - the paperwork requirements and obstacles to coverage can be quite time-consuming and add to the stress of managing a health situation when you can least afford it. .
Here’s a list of what Antara coverage offers that NHIF does NOT:
- Unlimited Outpatient Consultations: You can see a doctor as many times as you need to without having to pay any copay, additional charge, or hidden fees.
- Unlimited Specialist Referrals: Your doctor can refer you to an array of Specialists, like cardiologists, gastroenterologists, etc… as often as needed, again without having to pay any copay, additional charge, or hidden fees.
- All prescribed tests and lab work
- All prescribed medication
- KES 100,000 Coverage for Pre-existing and Chronic conditions such as High Blood Pressure, Diabetes, and Asthma.
Also, NHIF alone doesn't include Antara's Health Navigation Service, which provides:
- Preventative Care and Screening
- Point of care service: you can speak to a health professional by phone, sms, whatsapp or the Antara App to receive virtual care and consult with a doctor
- Care Coordination: Antara can organize additional care such as nutritional support, physiotherapy, and fitness support
- Care Management: a dedicated health professional to accompany all Antara members on every step of their health journey
- And much more!
Plus, you can also purchase KES 1,000,000 in Inpatient coverage for hospital stays that also includes ICU cover.
So Why do I need NHIF if I’ve signed up with Antara?
Because NHIF offers very specific kinds of coverage and benefits. We designed Antara to work hand in hand with NHIF's strengths to offer our members unbeatable value, quality, and protection.
Here are a few examples of how NHIF can enhance your Antara coverage:
- Antara members’ spouses and children, who are not covered with us, can be registered with NHIF as dependents, and so be able to get a level of health coverage.
- There are certain procedures for which Antara members would be able to draw on NHIF coverage to supplement services we offer. For example, if an MRI (magnetic resonance image) were needed, the cost of this would be covered in large part by NHIF.
- In case of an emergency, Antara members can also access the nearest facility that is under contract with NHIF to get immediate assistance if there is no Antara partner facility nearby.
- NHIF offers complementary coverage for certain chronic conditions such as cancer and renal care, including dialysis.