• Author: Raymond
• Category: Affordable Health Insurance

How SHA and SHIF Work in Kenya: 2026 Guide | Imana

Understand SHA and SHIF in Kenya: registration, contributions, healthcare access and how private medical insurance can complement public benefits in 2026.

How SHA and SHIF Work in Kenya: Registration, Contributions and Private Medical Insurance

By Raymond Momanyi, Founder & CEO, Imana Insurance Agency Kenya Ltd
Updated: 2 October 2026

The Social Health Authority administers Kenya’s public social health insurance system. The Social Health Insurance Fund is one of the funds within that system. Understanding the difference helps you check your registration, contributions and eligibility before seeking treatment.

Kenya began the operational transition from the National Hospital Insurance Fund to the Social Health Authority on 1 October 2024. For individuals, families and employers, the practical questions are straightforward: How do you register? How are contributions calculated? Where can you receive treatment? How does private medical insurance work alongside public benefits?

This guide explains those questions and the checks to make before visiting a hospital.

What Is SHA?

SHA stands for Social Health Authority. It administers the public healthcare financing framework established under the Social Health Insurance Act, 2023.

People often use “SHA” and “SHIF” interchangeably, but the terms describe different things. SHA is the administering authority. SHIF is the Social Health Insurance Fund.

For registration and account services, start with the official SHA website.

What Is SHIF?

SHIF stands for Social Health Insurance Fund. It pools contributions to finance eligible healthcare services under the applicable benefit package.

The wider framework includes three funds:

Primary Healthcare Fund

This fund supports primary healthcare services, including preventive and basic care within the applicable service arrangements.

Social Health Insurance Fund

SHIF finances eligible services under its benefit package. Treatment access depends on the service requested, membership requirements, contracted facilities and applicable authorisation rules.

Emergency, Chronic and Critical Illness Fund

This fund supports specified emergency, chronic and critical illness services under its eligibility and funding rules.

The funds have different functions. Registration should not be interpreted as an unlimited entitlement to every service at every hospital.

What Changed When SHA Replaced NHIF?

The transition introduced a different contribution framework, fund structure and administrative system.

For members, the key action is to confirm that their current SHA records are correct. An old NHIF card or contribution record alone should not be relied on as proof of current eligibility.

Check:

• Your identity and contact details.
• Registered dependants.
• Your contribution assessment and payment record.
• Eligibility for the service you need.
• Whether the chosen facility is contracted for that service.

Employers should also verify employee registration and contribution records through the official employer system. SHA Employer Portal

How Much Are SHIF Contributions?

Salaried Employees

The published 2024 regulations provide for a contribution of 2.75% of gross salary or wages, subject to a minimum monthly contribution of KSh 300.

For example, a gross monthly salary of KSh 50,000 produces a contribution of:

KSh 50,000 × 2.75% = KSh 1,375 per month.

Employers handle applicable deductions and remittances through the prescribed process.

Non-Salaried Households

For households whose income does not come from salaried employment, contributions are assessed through the prescribed means-testing process.

The published regulations provide for an annual contribution based on assessed household income, with a minimum equivalent of KSh 300 per month. Confirm your assessment and payment schedule directly with SHA.

Households Requiring Financial Assistance

The framework provides for identification of eligible households requiring government-supported contributions. Assistance depends on the prescribed assessment and approval process.

Use your current SHA assessment when making payments. Social Health Insurance General Regulations, 2024

How to Register for SHA

Begin through the official SHA website and follow its current registration instructions.

Have the required identification and household information available. Depending on your circumstances, you may need identity documents and supporting details for your dependants.

After registration:

1. Check that your personal details are accurate.
2. Confirm that eligible dependants appear correctly.
3. Review your contribution assessment.
4. Follow the official payment instructions.
5. Check your account status before planned treatment.

Use official channels for account changes and payment guidance. Registration, payment and eligibility for a specific benefit are separate matters that should each be confirmed.

What Healthcare Services Can You Access?

The SHA framework includes benefit arrangements for primary care, hospital treatment and specified emergency, chronic and critical illness services.

Depending on the applicable package and eligibility rules, services may include consultations, diagnostics, maternity care, surgery and treatment for certain serious conditions.

Before relying on a benefit, confirm:

• Whether the specific treatment is covered.
• Which fund and benefit rules apply.
• Whether a referral or authorisation is required.
• Whether the hospital is contracted for that service.
• Any applicable limits or remaining balance.
• Any charges payable by the patient.

Benefit packages and tariffs can change. Obtain current confirmation for planned treatment rather than relying on an old benefit list.

Can You Use SHA at a Private Hospital?

Access depends on the hospital’s current contractual arrangements and the service being requested.

A facility’s participation in SHA does not automatically establish that every treatment, specialist or room category is available under the public benefit package.

Before an appointment or planned admission, ask the hospital:

• Do you accept SHA for this particular service?
• What referral or approval documents are required?
• What amount is eligible under the applicable package?
• Are there charges I will need to pay?
• Can you provide an estimate before treatment?

For an emergency, seek urgent medical care. Administrative checks should not delay seeking treatment.

How Does SHA Work with Private Medical Insurance?

SHA benefits and private medical insurance may coordinate for eligible treatment. The payment process depends on the public benefit rules, hospital arrangements and private policy wording.

Private insurance may provide additional eligible limits, services or hospital choices. It does not automatically pay every amount left after a SHA assessment.

For example, a hospital bill may contain:

• Charges eligible under SHA.
• Charges eligible under the private policy.
• Charges excluded from both arrangements.
• Co-payments, excesses or amounts above benefit limits.

The patient may remain responsible for some costs.

Before planned treatment, ask your private insurer how it calculates any SHA deduction and what happens if SHA does not approve the service.

Read Imana’s related article on How SHA/SHIF and Private Medical Insurance Work Together. Apply the current policy terms to your circumstances.

Does Private Medical Insurance Replace SHIF Contributions?

Private medical insurance does not remove applicable statutory registration or contribution obligations.

For employers, a corporate medical scheme and statutory contributions serve separate functions. Both should be addressed through the relevant administrative processes.

Individuals should also confirm their SHA position when purchasing or renewing private cover.

What If Your Private Policy Still Mentions NHIF?

Some published brochures and older policy documents contain phrases such as “net of NHIF.”

Do not assume how that wording applies under the current system. Ask the insurer or intermediary for written clarification.

Useful questions include:

• Has the NHIF clause been replaced by a SHA/SHIF clause?
• Is the deduction based on an actual payment or an assumed benefit?
• What happens if the hospital or service is not contracted?
• Who pays if public benefits are unavailable?
• Which document confirms the current arrangement?

This clarification can help prevent unexpected charges at discharge.

How to Check Your Status Before Visiting a Hospital

Before a planned visit, review your account through official SHA channels.

Confirm your registration, dependant details, payment position and any eligibility requirements for the intended service.

Then contact the hospital to establish whether it accepts the relevant benefit and requires a referral or prior approval.

If you also have private insurance, check its authorisation requirements and available limits separately.

Read Imana’s guide to Confirming Your SHA/SHIF Status Before Visiting a Hospital.

Choosing Private Medical Cover to Complement Your Needs

Start with your preferred hospitals, household needs and sustainable premium budget.

Compare:

• Inpatient and outpatient benefits.
• Maternity and newborn protection.
• Chronic and pre-existing condition provisions.
• Waiting periods.
• Condition-specific sub-limits.
• Dental and optical options.
• Co-payments and excesses.
• Family-shared versus individual limits.
• SHA coordination clauses.

A large headline limit can still contain smaller allowances for particular conditions. Likewise, an active policy may have benefits that remain subject to waiting periods.

Explore Imana’s Health and Medical Insurance services and Imana Health and Microhealth options.

Frequently Asked Questions

Are SHA and SHIF the Same?

SHA is the administering authority. SHIF is the Social Health Insurance Fund within the wider framework.

When Did the Transition from NHIF Begin?

The operational transition began on 1 October 2024.

How Much Is the Contribution on a KSh 50,000 Gross Salary?

At 2.75%, the contribution is KSh 1,375 per month. Confirm the applicable payroll treatment and current requirements.

How Are Contributions Calculated for Self-Employed People?

Non-salaried household contributions are determined through the prescribed means-testing process. Check your official assessment and payment schedule.

Does Registration Mean Every Hospital Bill Is Covered?

No. Eligibility depends on the service, benefit package, facility arrangements, limits and applicable rules.

Can SHA and Private Insurance Pay Towards the Same Treatment?

They may coordinate for eligible treatment. Confirm the authorisation process, payment calculations and any patient contribution before planned care.

Will Private Insurance Pay Every Remaining Balance?

Payment depends on the private policy’s terms, exclusions, limits and conditions. Some charges may remain payable by you.

Where Should I Get Current Benefit Information?

Use the official SHA website, official Ministry of Health guidance and the treating facility. For private insurance, request the current policy wording and benefit schedule.

Related Imana Guides and Service Pages

For more information about medical insurance and choosing suitable protection, explore:

• Understanding the Social Health Authority and SHIF.
• Health Insurance Waiting Periods and Other Terms Simplified.
• Five Easy Steps to Buying Health Insurance in Kenya.
• Affordable Health Cover for Families and Individuals.
• Maternity Insurance in Kenya: Top Five Considerations.
• Chama, Welfare Group and Self-Help Insurance.
• Corporate and SME Insurance.
• Health Insurance Quotation.
• Microhealth Insurance Registration.
• Imana Blog Archive.

Older articles may describe earlier benefits or policy terms. Confirm current arrangements before relying on them.

Compare Medical Insurance Quotations with Imana

Imana Insurance Agency Kenya Ltd is a Westlands-based insurance intermediary helping individuals, families and businesses compare insurance quotations from licensed Kenyan insurers across Motor, Medical, WIBA, PSV, Travel, Motorcycle, Cyber, SME/Corporate and other insurance classes.

Imana can help you compare private medical insurance options and identify policy questions that require insurer clarification.

Start through:

• Imana Insurance Quotation Comparison Landing Page for insurance quotation comparison enquiries.
• Imana Insurance Authority and Information Page for agency services and insurance guidance.
• MyKava for Travel, Accommodation and Insurance to explore available options.

Visit: 4th Floor, Krishna Centre, Woodvale Grove, Westlands, Nairobi.
Call or WhatsApp: +254 796 209 402.
Email: insurance@imana.co.ke.

Understand your public benefits. Check your private cover. Know which costs may remain yours before planned treatment.

About the Author

Raymond Momanyi is the Founder & CEO of Imana Insurance Agency Kenya Ltd. He helps individuals, families and businesses compare insurance options and understand policy terms.

This article provides general information. SHA contributions, benefit packages, tariffs and access requirements may change. Private insurance is subject to insurer acceptance, policy terms, waiting periods, exclusions and limits. Confirm current requirements through official SHA channels and your insurer.