If you’re looking to find information to get gharama za bima ya afya (NHIF) National Health Insurance Fund, then this article is for you. In this article, we will take a look at the cost of becoming a member of (NHIF) and the benefits it provides.
The National Health Insurance Fund (NHIF) is a Social Health Insurance Institution established under the National Health Insurance Act, Cap 395 with the main objective of ensuring accessibility of health care services to people in Tanzania.
According to the NHIF Act, employees in the public sector are obliged to register themselves and contribute to the Fund a total of six percent (6%) of their monthly basic salary which is equally shared between the employer and employee. However, the Fund has put in place separate contribution arrangements for other groups that join the Fund voluntarily.
Despite the compulsory enrollment arrangement to public servants, the Fund has expanded its coverage to include other groups like Councilors, private companies, education institutions, private individuals, children under the age of 18, farmers in cooperatives as well as organized registered groups like Machinga and Bodaboda groups. The Fund is also administering the Bunge Health Insurance Scheme and covers Members of the Zanzibar House of Representatives.
Gharama Bima ya Afya (NHIF) Packages in Tanzania
| NA. | FAMILIA | NAJALI AFYA 1 | WEKEZA AFYA 1 | TIMIZA AFYA 1 | NAJALI AFYA 2 | WEKEZA AFYA 2 | TIMIZA AFYA 2 | NAJALI AFYA 3 | WEKEZA AFYA 3 | TIMIZA AFYA 3 |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Mtu mmoja | 192,000 | 384,000 | 516,000 | 240,000 | 444,000 | 612,000 | 360,000 | 660,000 | 984,000 |
| 2 | Wanandoa | 384,000 | 732,000 | 996,000 | 456,000 | 864,000 | 1,188,000 | 684,000 | 1,284,000 | 1,908,000 |
| 3 | Wanandoa + Mtoto 1 | 504,000 | 924,000 | 1,272,000 | 576,000 | 1,068,000 | 1,464,000 | |||
| 4 | Wanandoa + Watoto 2 | 612,000 | 1,116,000 | 1,536,000 | 696,000 | 1,248,000 | 1,728,000 | |||
| 5 | Wanandoa + Watoto 3 | 720,000 | 1,284,000 | 1,788,000 | 804,000 | 1,416,000 | 1,980,000 | |||
| 6 | Wanandoa + Watoto 4 | 816,000 | 1,452,000 | 2,028,000 | 900,000 | 1,584,000 | 2,220,000 | |||
| 7 | Mtu mmoja+ Mtoto 1 | 312,000 | 576,000 | 792,000 | 360,000 | 648,000 | 888,000 | |||
| 8 | Mtu mmoja+ Watoto 2 | 432,000 | 756,000 | 1,056,000 | 468,000 | 828,000 | 1,152,000 | |||
| 9 | Mtu mmoja+ Watoto 3 | 540,000 | 924,000 | 1,308,000 | 576,000 | 996,000 | 1,404,000 | |||
| 10 | Mtu mmoja+ Watoto 4 | 636,000 | 1,092,000 | 1,548,000 | 672,000 | 1,164,000 | 1,644,000 |
Bima ya Afya (NHIF) Packages Age Limit
The age limit for Bima ya Afya (NHIF) National Health Insurance Fund is a crucial factor to consider when deciding which package to choose. With that said, below is the table that shows age limit for all NHIF packages available in Tanzania.
| PACKAGE NAME | AGE LIMIT |
|---|---|
| NAJALI AFYA 1 | Age From 18 To 35 |
| WEKEZA AFYA 1 | Age From 18 To 35 |
| TIMIZA AFYA 1 | Age From 18 To 35 |
| NAJALI AFYA 2 | Age From 35 To 59 |
| WEKAZA AFYA 2 | Age From 35 To 59 |
| TIMIZA AFYA 2 | Age From 35 To 59 |
| NAJALI AFYA 3 | Age From 60+ |
| WEKEZA AFYA 3 | Age From 60+ |
| TIMIZA AFYA 3 | Age From 60+ |
Bima ya Afya (NHIF) Tanzania Benefits
Bima ya Afya (NHIF) provides a wide range of medical services, including outpatient and inpatient care, laboratory services, and diagnostic tests and more. The fund has a network of over 1,500+ hospitals and clinics across Tanzania, making it easy for members to access healthcare services whenever they need it.
Moreover, members can choose any of the NHIF-affiliated healthcare providers, giving them more control over their medical care. Below you can find table contain fund benefits available for all members of each packages mentioned above.
| NA | MAFAO | BENEFITS NAJALI AFYA PACK | BENEFITS WEKEZA AFYA PACK | BENEFITS TIMIZA AFYA PACK |
|---|---|---|---|---|
| 1. | Ada ya kujiandikisha na kumwona daktari | Inalipiwa katika ngazi zote za vituo. | Inalipiwa katika ngazi zote za vituo. | Inalipiwa katika ngazi zote za vituo |
| 2. | Huduma za kulazwa | Inapatikana kwa jumla ya siku zisizozidi 30 kwa mwaka kwa kila mnufaika mmoja. | Inapatikana kwa jumla ya siku zisizozidi 45 kwa mwaka kwa kila mnufaika mmoja. | Inapatikana kwa jumla ya siku zisizozidi 60 kwa mwaka kwa kila mnufaika mmoja. |
| 3. | Huduma za dawa | Dawa zote zilizoainishwa katika Kitita cha Mafao cha NHIF Daraja A, B, C, D na S | Dawa zote zilizoainishwa katika Kitita cha Mafao cha NHIF Daraja A, B, C, D na S | Dawa zote zilizoainishwa katika Kitita cha Mafao cha NHIF Daraja A, B, C, D na S |
| VIPIMO VYA MAABARA NA UCHUNGUZI | ||||
| 4. | Aina za Vipimo | 162 | 197 | 223 |
| X-RAY | Inapatikana | Inapatikana | Inapatikana | |
| ECHO & EEG | Inapatikana | Inapatikana | Inapatikana | |
| Ultrasound | Inapatikana | Inapatikana | Inapatikana | |
| 5. | HUDUMA ZA KINYWA NA MENO | |||
| Kung’oa na kuziba meno | Inapatikana | Inapatikana | Inapatikana | |
| 6. | HUDUMA ZA UZAZI | |||
| Kujifungua kawaida | Inapatikana baada ya kuchangia mfululizo katika kipindi cha miaka miwili. | Inapatikana kuanzia mwaka wa pili wa kuchangia mfululizo. | Inapatikana kuanzia mwaka wa pili wa kuchangia mfululizo. | |
| Kujifungua kwa upasuaji | Inapatikana baada ya kuchangia mfululizo katika kipindi cha miaka miwili, | Inapatikana kuanzia mwaka wa pili wa kuchangia mfululizo. | Inapatikana kuanzia mwaka wa pili wa kuchangia mfululizo. | |
| 7. | HUDUMA ZA MATIBABU YA KIBINGWA | |||
| Huduma za kibingwa | Zinapatikana mpaka ngazi ya Hospitali za Mkoa na kwa rufaa hadi Hospitali za Rufaa za Kanda na Taifa. | Zinapatikana mpaka ngazi ya Hospitali za Mkoa na kwa rufaa hadi Hospitali za Rufaa za Kanda na Taifa. | Zinapatikana mpaka ngazi ya Hospitali za Mkoa na kwa rufaa hadi Hospitali za Rufaa za Kanda na Taifa. | |
| 8. | HUDUMA ZA UPASUAJI | |||
| Aina za upasuaji mdogo | 27 | 30 | 50 | |
| Aina za upasuaji mkubwa | 14 | 36 | 80 |
National Health Insurance Fund (Bima ya Afya) FAQs
How long does it take to get Bima ya Afya (NHIF)
It typically takes 1-3 months to get Bima ya Afya (NHIF) coverage after enrolling and submitting the necessary documentation. The exact processing time may vary depending on the package and volume of applications received by NHIF.
How to Join Bima ya Afya (NHIF)
Joining Bima ya Afya (NHIF), you need to obtain a membership form, which can be found at any NHIF office or downloaded from their website. Next, fill out the form with accurate information and attach the required documents. After submitting the completed form and documents, either in person at an NHIF office or via their online portal, you'll need to wait for the processing of your application.
