These regulations were developed in the exercise of the powers conferred by sections 24, 30, 46)2), 47(5) and 50(1) of the Social Health Insurance Act, 2023, by the Cabinet Secretary for Health, in consultation with the Board for the Social Health Authority.
This Act establishes the framework for the management of social health insurance; provides for the establishment of the Social Health Authority; gives effect to Article 43(1)(a) of the Constitution; and for connected purposes.
This document provides the benefits package of the National Health Insurance Scheme as offered to its beneficiaries through private health providers.
This Act provides for sound financing for the national health system; provides for universal access to quality insured health care services; establishes the National Health Insurance Management Authority and provides for its functions and powers; establishes the National Health Insurance Scheme and provides for its systems, procedures and operation; establishes the National Health Insurance Fund and provides for contributions to and payments from the Fund; provides for accreditation criteria and conditions in respect of insured health care services; provides for complaints and appeals processes; provides for the progressive establishment of provincial and district health offices of the Authority; and provides for matters connected with, or incidental to the foregoing.
The Insurance Act
This Act amends and consolidates the Law relating to insurance, and regulates the business of insurance and connected purposes.