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What you need to know about Bomet Universal Health Coverage.
  • The focus is on providing efficient preventive, curative, rehabilitative and palliative health care services
  • Every needy household within the county are expected to benefit from Universal Health Coverage package.
  • Among critical services offered include laboratory investigation, drugs, health education, wellness and counselling, physiotherapy services, immunization, vaccines as per KEPI schedule, x rays and surgical operations.
  • In patient services such as hospital stay with health care diagnosis, procedures and treatment i.e. bed charges nursing care, lab test radiology exams, physician /physiotherapy fee, medication and dressing.
  • Others such as ICU, Renal dialysis, Maternity, Rehabilitation package, Surgical package including transplant will be offered under the scheme.
  • The County Government has also put up a CT Scan facility at Longisa County Referral Hospital and is at an advance stage of setting up a modern Mother and Child Wellness Centre at Longisa Hospital.
  • The County Government recently launched an X-ray and theatre facility at Sigor SubCounty Hospital.
  • Under the UHC program, the County Government of Bomet will support 10,000 vulnerable households across the county. However, people in informal sector are encouraged to register and subscribe with NHIF and benefits from the same package.
Bomet UHC benefit package
  1. In-patient care
  2. Maternal & child health
  3. Renal dialysis care
  4. Rehabilitation for drug and substance abuse
  5. Out-patient care
  6. Oncology treatment
  7. Radiology: MRI & CT Scan, Ultrasound
  8. Overseas treatment
  9. Surgeries including transplants
  10. Emergency evacuation service
People centered Quality Healthcare services
  • Improved quality of services and patient safety
  • Strengthened networks of close to client Primary care organized as dispensaries/L3 or health centers /L3 with the backup of specialized and hospital services responsible for defined populations (Primary Care Networks/PCNs)
  • Investment in community and primary Health care services/ Invest in preventive and promotive services and social determinants of Health (water, sanitation, nutrition).
  • Equipping health facilities including with specialized equipment; key focus on critical equipment for primary care facilities (CT scan at Longisa, Theater services in three Hospitals, Laboratory services in primary health facilities)
  • Infrastructure development mainly to strengthen existing health facilities
  • Investment in Human resource for Health; (Increased Human resources for Health; skill development
  • Investment in health Commodities and Technologies
BOMET UNIVERSAL HEALTH COVERAGE PACKAGE
 

BOMET UNIVERSAL HEALTH COVERAGE PACKAGE

 

BENEFIT PACKAGE  PACKAGE CONTENT ACCESS
Out Patient Care Cover Cover includes; Consultation with a GP, laboratory investigations, daycare procedures, drugs & dispensation, health education, wellness and counseling, physiotherapy services, immunization / vaccines as per KEPI schedule Capitated Facilities
Inpatient cover Cover for hospital stay with health care diagnosis, procedure and treatment

Includes Consultations, Accomodation/bed charges, nursing care, diagnostic laboratory tests, Radiology examinations, Physician’s, Physiotherapist’s fees, Specialist consultations or visits, Prescribed medications and dressings.

Comprehensive inpatient: No copayment

Contracted facilities under contract A and B.

Non Comprehensive Inpatient: member tops up deficit by self-pay or co-insurance.

Contracted providers at Contract C

Maternity Caters for pregnancy related health services: facilitate labor, delivery through Normal delivery or caesarian section and the aftercare for the mother together with the newborn. Contracted facilities under contract A and B.
Renal Dialysis It caters for hemodialysis for the needed care plan including Specialists’ reviews, nursing and dialysis services, intra-care and dispensed medications, routine laboratory tests, nutrition, counselling and follow up Contracted renal dialysis facilities.
Rehabilitation Package: Drug and Substance Abuse Includes rehabilitation treatment for persons addicted to harmful or hazardous psychoactive substances. Contracted facilities
Radiology Package Includes diagnostic imaging services for MRI, CT Scans and Ultrasound Contracted facilities provided under referral system
Surgical Package Includes all surgical procedures including transplants with an exception of cosmetic surgeries Contracted facilities as per Level of Care

(Comprehensive cover in Contract A&B facilities)

Minor Surgeries

Major Surgeries

Specialized surgeries

Oncology Package Includes treatment for cancer patients using radiotherapy and chemotherapy case management Contracted Facilities

20 Radiotherapy sessions per beneficiary capped @ Kshs. 18,000 per five sessions

6 chemotherapy sessions for basic treatment capped @ Kshs. 25,000 per session

4 chemotherapy sessions for complex treatment capped @ Kshs. 150,000

Foreign Treatment Cover for treatment costs pertaining to medical and surgical interventions and PET Scan Imaging, arising from a condition that warrants treatment that’s not available in Kenya. Pre-requisite documents as stipulated I the benefits administration guidelines

Capped @ 500,000 for specialized surgeries

Emergency Care Package On site evacuation ; Transportation & transfer of a sick member or dependents for treatment to nearest NHIF declared hospital Kenya Red Cross

1199

0700395395

0738 395395

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