Understanding the Social Health Insurance Fund and What’s Changing in 2025
What is SHIF?
The Social Health Insurance Fund (SHIF) is Kenya’s new universal healthcare scheme introduced under the Social Health Insurance Act, 2023. It replaces the National Health Insurance Fund (NHIF) and is part of the government's efforts to achieve Universal Health Coverage (UHC).
Unlike NHIF, which operated largely as a social insurance scheme, SHIF is mandatory for all Kenyans. It’s designed to provide comprehensive, equitable, and accessible healthcare services — regardless of income status.
Why Replace NHIF?
NHIF had long-standing structural issues — inefficiencies, gaps in coverage, and widening health inequalities. SHIF addresses these challenges through:
-
Better governance and digitization
-
Mandatory contributions from all income groups
-
A shift from passive reimbursement to strategic healthcare financing
-
Integrated coverage for outpatient, emergency, and chronic care
SHIF Structure: The 3 New Funds
In 2025, SHIF operations are anchored around three distinct funds:
| Fund Name | Purpose |
|---|---|
| Primary Healthcare Fund | Covers outpatient care at community, dispensary, and clinic levels. |
| Emergency, Chronic & Critical Illness Fund | Covers emergencies and long-term illnesses. |
| Social Health Insurance Fund (SHIF) | Core fund pooling contributions to finance general health coverage. |
Contributions in 2025: What You’ll Pay
Contributions are now income-based, not flat-rate like NHIF. SHIF rates are set at 2.75% of gross monthly income, with a minimum of KES 300 for those without formal income.
Examples:
-
Gross salary KES 50,000 → Pay KES 1,375 per month
-
Gross salary KES 10,000 → Pay KES 275 per month
-
No income → Pay KES 300 per month (State may subsidize for indigents)
Key 2025 Updates You Must Know
| Update | Impact |
|---|---|
| Mandatory Registration for All | All Kenyans aged 18 and above must register, including long-term foreigners. |
| Digital ID for Access | Health services accessed only via biometric identification. |
| Access Based on Facility Choice | You must select your preferred primary care facility. |
| Emergency Access Remains Free | Emergency care available to all, regardless of registration. |
| Rollout Begins January 2025 | Implementation will roll out in phases starting January 2025. |
Frequently Asked Questions
Is SHIF only for salaried people?
No. Even informal workers and the unemployed are required to register and contribute.
Can I continue using my NHIF card?
No. NHIF is being phased out. SHIF replaces it fully by early 2025.
What happens if I don’t pay?
You may be locked out of essential health services, including treatment, tests, and referrals.
Can I use private insurance instead?
Yes, but SHIF is mandatory even if you have private insurance.
Final Thoughts
SHIF is not just another public scheme — it’s a national commitment to fair, inclusive, and quality healthcare. It aims to reduce out-of-pocket costs, eliminate financial discrimination, and bring healthcare closer to the people.
This is your opportunity to prepare, participate, and protect your health future.
Need Help Understanding SHIF for Your Business or Employees?
Let’s simplify compliance and keep your team covered.
Call/WhatsApp: +254 702 339 699
Email: sales@faidihr.com