The National Health Insurance Fund
(NHIF) is a Social Health Insurance Scheme established by CAP 395 of
1999 with the main objective of ensuring accessibility of health care
services to all Tanzanians. Despite the compulsory enrollment
arrangement to public servants, the Fund has managed to expand its
coverage to include councilors, private companies, religious and
education institutions, private individuals, children under 18 (TOTO
Afya), peasants in cooperatives (Ushirika Afya) as well as mutual
groups, whereby all members equally access health services in all
certified health facilities. The Fund is also administering the Bunge
Health Insurance Scheme, on behalf of the National Assembly of Tanzania
and covers members of Zanzibar House of Representatives.
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The
management of the Fund is vested to the Board of Directors. However,
day to day operations of the Fund are overseen by the Director General
of the Fund. NHIF is a Government agency under the Ministry of Health
Community Development, Gender, Elderly and Children (MHCDGEC), which
considers health insurance as a societal affair rather than an
individual need and operates under the principle of risk sharing and
solidarity among members.
Core Functions of the FundAs it is specified by the NHIF Act, core functions of the Fund are to:-
- Register members and issue identity cards;
- Certify and inspect health service providers
- Undertake quality assurance processes;
- Inspect employers to check compliance;
- Collect monthly and periodic contributions;
- Invest the funds collected in order to earn income;
- Account for the funds so collected and invested;
- Process providers’ claims;
- Carry out Actuarial Assessment and Valuation; and
- Provide health insurance education to the public with the aim of marketing it and enhance public relations.
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Contribution
The amount that one contributes to the Scheme largely depends on the ability to pay and is not determined by age, sex or previous utilization rate of each respective member(s).
The amount that one contributes to the Scheme largely depends on the ability to pay and is not determined by age, sex or previous utilization rate of each respective member(s).
According
to the NHIF Act, employees in the public sector are obliged to register
themselves and contribute to the Fund a total of six (6) percent of
monthly basic salary which is equally shared between the employer and
employee. However, after the amendment of the NHIF Act, the Fund has put
in place a separate contribution arrangement for other groups
registered by the Fund.
Beneficiaries
NHIF beneficiaries in a family include the contributing member, spouse and up to four legal dependents. Under NHIF context, legal dependents include biological children or legally adopted children, parents and in laws. NHIF coverage is growing rapidly and as of March, 2019 it stood at 4,170,155 beneficiaries, an exponential increase as compared to its size during the initial years.
NHIF beneficiaries in a family include the contributing member, spouse and up to four legal dependents. Under NHIF context, legal dependents include biological children or legally adopted children, parents and in laws. NHIF coverage is growing rapidly and as of March, 2019 it stood at 4,170,155 beneficiaries, an exponential increase as compared to its size during the initial years.
The
Fund also manages the Community Health Fund (CHF) with a total of
12,799,788 beneficiaries thus bringing the total size of beneficiaries
for both NHIF and CHF to 16,969,943 by the end of March, 2019 equivalent
to 32% of the total population.
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Categories of NHIF MembersThe Fund expanded its range of categories of membership to enable other members than public employees to join, in the efforts to ensure more members join the Fund. These categories include:-
- Public employees
- Students
- Retired NHIF members
- Private individuals (with no employers/self-employed)
- Employees from the private sector such as Private Companies, Associations and NGOs
- Religious leaders such as Clergies.
- TOTO Afya Kadi for children under 18 years
- Ushirika Afya for peasants in Cooperative Societies
- Bunge Scheme for Members of Parliament
- Members of Zanzibar House of Representatives
- Councilors
NHIF Benefits Package
The following services are provided to beneficiaries;
a) Registration and/or consultation;
b) Medicines and medical consumables;
c) Investigations;
d) Dental and ophthalmologist services;
e) Inpatient care services;
f) Procedures;
g) Surgical services;
h) Medical and orthopedic appliances;
i) Rehabilitative services.
NHIF also facilitates provision of services that are normally out of general package under special agreements with some employers.
Categories and Network of Certified Health Facilities
The Fund undertakes certifications of facilities that are fully registered by the Ministry of Health, Community Development, Gender, Elderly and Children. Currently the Fund has certified the following levels of facilities to serve Fund’s beneficiaries:-
- National Referral,
- Zonal Referral,
- Regional Referral and
- District Hospitals
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- Specialized Clinics,
- Health Centers,
- Dispensaries,
- ADDO’s and;
- Pharmacies.
NHIF Medical Outreach Program
The
Fund introduced a periodic medical outreach program which is conducted
once every quarter in a selected and needed region. The program by
involves medical specialists of various disciplines. The objective of
the program is to ensure that vulnerable communities in underserved
areas can access specialized quality healthcare services, and for the
Fund this is part of the Corporate Social Responsibility.
CHF Operations
Community
Health Fund (CHF) is a voluntary scheme established by the Parliament
Act No 1 of 2001. The Scheme was introduced in the country as part of
the so Ministry of Health and Social Welfare (MOHSW) endeavor for the
quality and affordable health care services through sustainable
financing mechanism and improved health care services management in the
communities. CHF was piloted in Igunga District in 1996 and its success
led it being rolled over to other district councils of Tanzania. CHF is a
pre-payment council based scheme aimed at facilitating the community to
access health care at an affordable contribution rate that is arranged
by the community itself.
The scheme
was at first administered by the MOHSW and PMO RALG until July, 2009
when the Government entrusted and deputized its function to the Fund
through a Cabinet decision NO. 36/2007. This Government decision aimed
at improving CHF operations and ensuring that it covers the majority of
informal workers in Tanzanians. Currently statistics indicate that, CHF
has been rolled over to 177 out of 181 councils operating under Local
Government Authorities through NHIF coordination’s.
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NHIF has established offices in all regions in Tanzania Mainland and Zanzibar to bring services closer to members who are under the Union Government. Each regional office is manned by a Regional Manager and contacts of offices can be seen through this link.
ISO 9001:2015 Certification
The National Health Insurance Fund is ISO 9001:2015 Certified.
Mission and Vision
Vision
To be the leading health insurance scheme of choice in the Sub-Saharan Region
Mission
Dedicated to providing quality social health insurance to beneficiaries to access health care services through a wide network of accredited health facilities.
Core Values
Members can confidently trust in the impeccable integrity of the NHIF. In all the approaches and behavior, the Fund will inculcate a culture that reflects the following values:-
- Integrity
- Accountability
- Innovativeness
- Courtesy
- Promptness
- Proactiveness
Dedicated to providing quality health care
ONLINE SERVICE
The Service Portal is designed, developed and hosted by National Health Insurance Fund(NHIF). The Portal’s main objective is to enable a one stop center interface for health care services delivery in a transparent, easy and cost effective manner from various Accredited Health Facilities for the benefit of its beneficiaries.
PROCEDURES:
Follow the following procedures to register.Use this link to apply http://nhif.or.tz/online_services#gsc.tab=0
or follow the steps below;-
- Click Self Employed on the Menu
- Enter your National ID/Passport/Alien ID
- If the Provided ID id Valid, the System will allow you to continue.
- Fill in all form fields.
- Attach a Scanned Copy of Your ID/PassPort/Alien Id.
- Attach PassPort Photo.
- If married, attach Your Marriage Certificate.
- Click Save. If you filled in all fields, the application will be submitted
- The system will notify you of the Application Status
- The system will also send a Notification SMS to the Contributor's Mobile Number
OR LOG IN HERE
