By Antony Mwangi – General Manager, Health – Heritage Insurance Company Ltd
In Kenya, the spirit of Harambee, pulling together to support one another is deeply embedded in our culture. Whether in villages or urban centres, it is not uncommon to be part of multiple WhatsApp groups each year, contributing to fundraisers for medical bills. Social media platforms are also flooded with urgent appeals for financial help to cover costly treatments. While this sense of communal support is admirable, it raises an uncomfortable question; should access to life-saving healthcare depend on goodwill and last-minute collections?
The Harsh Reality of Medical Expenses
Kenya’s economic environment remains challenging, with rising inflation, increasing taxes, and shrinking disposable incomes. Unlike discretionary expenses, healthcare is not something one can choose to forego or postpone. When illness or injury strikes, treatment is a necessity, not a luxury. Yet, without a solid health insurance plan, many families are forced to deplete their savings or take on debt to cover medical expenses. It is often said that most Kenyans are just one hospital bill away from financial ruin, a stark reality that underscores the importance of health insurance.
Recognizing the need for universal healthcare, the government has transitioned from the National Hospital Insurance Fund (NHIF) to the Social Health Authority (SHA) under the Social Health Insurance Act No. 16 of 2023. This shift introduces the Social Health Insurance Fund (SHIF), alongside the Primary Healthcare Fund and the Emergency, Chronic and Critical Illness Fund, with the aim of creating a more sustainable healthcare financing system.
Under this framework, all Kenyan residents must register with SHA. Salaried individuals contribute 2.75% of their gross monthly income, while non-salaried contributors pay 2.75% of their annual household income, with a minimum contribution of KES 300 per month. While this system aims to provide universal coverage, supplementary health insurance is essential for broader protection, quicker access to treatment, and enhanced healthcare options.
As medical advancements continue and healthcare costs rise, relying solely on public health schemes may not be sufficient. Private health insurance provides access to a wider range of medical facilities, specialists, and treatments, ensuring quality healthcare without long waiting periods.
A well-structured health insurance plan allows individuals to manage medical expenses effectively, keeping their savings intact for other life goals such as homeownership, children’s education, and retirement. Contrary to popular belief, private medical insurance is not always expensive, there are affordable plans tailored to different needs, making quality healthcare accessible.
A Tailored Approach to Healthcare Protection
At Heritage Insurance, we recognize the diverse healthcare needs of individuals, families, and businesses. Our HeriAfya plan offers comprehensive coverage, enabling policyholders to focus on their financial goals with the assurance that their health is well protected. With benefits extending up to KES 15 million annually, HeriAfya provides peace of mind by covering medical emergencies and routine healthcare needs alike.
Beyond individual policies, employer-sponsored health insurance is an invaluable investment. Corporate health plans promote employee well-being, reducing absenteeism, lowering stress levels, and fostering a healthier, more productive workforce. By prioritizing healthcare coverage, businesses can create a positive impact on both their employees and overall operational success.
Health insurance is not just a financial decision, it is a fundamental necessity. The reliance on Harambee to fund medical treatments is unsustainable in the long run. Investing in a reliable health insurance plan, whether through public schemes like SHA or private options like HeriAfya, ensures that individuals and families can access quality healthcare without financial distress. The real question isn’t whether you can afford health insurance, but whether you can afford to be without it.