VIFURUSHI VIPYA NHIF
NATIONAL HEALTH INSURANCE FUND PACKAGES 1. Health Insurance Packages The NHIF Health Insurance Packages, namely Ngorongoro Health and Serengeti Health, are schemes that enable an…
NATIONAL HEALTH INSURANCE FUND PACKAGES
1. Health Insurance Packages
The NHIF Health Insurance Packages, namely Ngorongoro Health and Serengeti Health, are schemes that enable an individual or family to choose and contribute to healthcare services before falling ill, ensuring access to medical treatment using health insurance without financial constraints.
2. Benefits of Joining Health Insurance Packages
- Broad coverage of basic and specialized medical services
- 10% discount on dependent contributions for family members
- Nationwide treatment at over 10,000 healthcare facilities, from dispensaries to national hospitals. Additionally, a referral system will be used at regional and national referral hospitals.
3. Benefits Provided to Members of Health Insurance Packages
| No. | Benefits | Serengeti Health | Ngorongoro Health |
|---|---|---|---|
| 1 | Doctor Consultation | General Practitioner, Specialist, and Senior Specialist | General Practitioner, Specialist, and Senior Specialist |
| 2 | Diagnostic Services | Laboratory, CT scan, MRI, Ultrasound, X-ray, ECHO, ECG | Laboratory, CT scan, MRI, Ultrasound, X-ray, ECHO, ECG |
| 3 | Medication for Non-Communicable Diseases | Diabetes, Hypertension, Sickle Cell, Heart Diseases, Kidney Diseases | Diabetes, Hypertension, Sickle Cell, Heart Diseases, Kidney Diseases |
| 4 | Inpatient Services | General Ward, Intensive Care Unit (ICU and HDU) | General Ward, Intensive Care Unit (ICU and HDU) |
| 5 | Maternity Services | Normal Delivery and Cesarean Section | Normal Delivery and Cesarean Section |
| 6 | Major and Minor Surgeries | Bone Surgery, Prostate Surgery, Abdominal Surgery, Neurosurgery, Blood and Heart Surgery, Ear, Nose, and Throat Surgery, Eye Surgery | Prostate Surgery, Abdominal Surgery |
| 7 | Dialysis Services | Peritoneal Dialysis | Peritoneal Dialysis |
| 8 | Cancer Services | Cancer Medication, Radiotherapy | Some Cancer Medications, Radiotherapy |
| 9 | Dental Services | Tooth Extraction, Filling, Cleaning, and Dentures | Tooth Extraction, Filling, and Cleaning |
| 10 | Physiotherapy Services | Available | Available |
| 11 | Emergency Services | Available | Available |
| 12 | Medical Implants | Available | Not Available |
4. Limits on Medical Costs for Beneficiaries
| Service | Serengeti Health | Ngorongoro Health |
|---|---|---|
| Annual Limit per Beneficiary | Annual Limit per Beneficiary | |
| Inpatient Services | TZS 22,000,000 | TZS 5,000,000 |
| Outpatient Services | TZS 3,000,000 | TZS 900,000 |
5. Contribution Rates for Health Insurance Package Members
| No. | Family Size | Contributor’s Age | ||||||
|---|---|---|---|---|---|---|---|---|
| 0 – 17 Years | 18 – 35 Years | 36 – 59 Years | 60+ Years | |||||
| Ngorongoro Health | Serengeti Health | Ngorongoro Health | Serengeti Health | Ngorongoro Health | Serengeti Health | Ngorongoro Health | ||
| 1 | Single | 240,000 | 660,000 | 432,000 | 792,000 | 540,000 | 1,620,000 | 708,000 |
| 2 | Couple | 820,800 | 1,504,800 | 1,026,000 | 3,078,000 | 1,345,200 | 6,338,400 | |
| 3 | Single + 1 Child | 648,000 | 1,386,000 | 756,000 | 2,214,000 | |||
| 4 | Single + 2 Children | 864,000 | 1,980,000 | 972,000 | 2,808,000 | |||
| 5 | Single + 3 Children | 1,080,000 | 2,574,000 | 1,188,000 | 3,402,000 | |||
| 6 | Single + 4 Children | 1,296,000 | 3,168,000 | 1,404,000 | 3,996,000 | |||
| 7 | Couple + 1 Child | 1,036,800 | 2,098,800 | 1,242,000 | 3,672,000 | |||
| 8 | Couple + 2 Children | 1,252,800 | 2,692,800 | 1,458,000 | 4,266,000 | |||
| 9 | Couple + 3 Children | 1,468,800 | 3,286,800 | 1,674,000 | 4,860,000 | |||
| 10 | Couple + 4 Children | 1,684,800 | 3,880,800 | 1,890,000 | 5,454,000 |
6. Important Considerations Before Joining a Health Insurance Package
i. National Identification Number,
ii. One colored passport-sized photo,
iii. A member wishing to register a spouse must attach:
a) One passport-sized photo of the spouse,
b) Verified marriage certificate number from the Registration, Insolvency, and Trusteeship Agency (RITA),
c) Spouse’s National Identification Number.
iv. To register a dependent child, you must have:
a) A passport-sized photo of the child,
b) Verified birth certificate number from RITA.
v. Each beneficiary will have an annual limit on medical expenses, so members are advised to closely monitor their usage and avoid unnecessary expenses.
vi. Members must wait 30 days after completing registration and payment procedures before accessing services.
vii. Members must renew their membership within thirty (30) days after reaching the membership expiry date. Members who fail to renew within the specified period will be considered new members and will have to wait for thirty (30) days.
viii. Dependents recognized under the packages include a spouse and up to four children (biological, adopted, or stepchildren) under the age of 21.
ix. A guarantor is required if the age of the member being registered is under eighteen (18).
x. Each beneficiary must fill out a health assessment form.
7. How to Register for Health Insurance Packages
i. Members can register themselves and their dependents online via the link https://selfservice.nhif.or.tz. Members eligible to use online services must be at least eighteen (18) years old and have a National Identification Number.
ii. After filling in the necessary information, the member will receive a payment control number to use for payment via bank or mobile networks.
iii. Payment can be made in full or in installments.
iv. The member will be issued an identification number or an electronic medical identification card (e-Card). Those with National Identification Numbers can access services using this card.
For more information, visit the nearest NHIF office or call toll-free number 199.
