The Social Health Authority (SHA) has issued a call for Expressions of Interest (EOI) from licensed overseas healthcare providers to deliver highly specialized medical treatments currently unavailable within Kenya.
This strategic move aims to significantly expand healthcare access for beneficiaries of the Social Health Insurance Fund (SHIF) and the Public Officers Medical Scheme Fund (POMSF) for the 2025-2026 period.
“The Authority is seeking overseas healthcare providers with demonstrated capacity to deliver medical interventions not readily available in the country,” SHA stated in its invitation notice.
The comprehensive contracting process will cover all aspects of patient care, including evaluation, treatment, accommodation, patient transfers, and post-treatment follow-up, aiming to reduce the financial and logistical burden on patients and their families.
This initiative is anchored in the Social Health Insurance Act of 2023 and the Public Finance Management (Public Officers Medical Scheme Fund) Regulations of 2024, which empower SHA to administer and manage access to specialized care, including treatment sought abroad.
Only medical interventions identified by the Benefits Package and Tariffs Advisory Panel (BPTAP) as unavailable in Kenya will qualify for overseas referral under SHIF.
While the current overseas treatment cap for SHIF beneficiaries is Ksh500,000, this amount is under review due to concerns that specialized procedures often exceed this limit.
For POMSF beneficiaries, additional specialized treatments may be accessed upon referral, with costs negotiated directly between SHA and the overseas provider.
The SHA, which replaced the National Health Insurance Fund (NHIF) on October 1, 2024, is striving to achieve Universal Health Coverage (UHC) in Kenya.
