SHA Reveals Why They Cannot Pay for Overseas Treatment Yet
Kenyans seeking specialised medical treatment abroad will continue to shoulder the financial burden despite contributing to the Social Health Insurance Fund (SHIF), after the Social Health Authority (SHA) confirmed it is not yet remitting payments to foreign hospitals.
The revelation was made on Wednesday, February 11, when SHA Chief Executive Officer Dr. Mercy Mwangangi appeared before the National Assembly Public Investments Committee on Social Services to respond to concerns over delayed overseas treatment coverage.
Addressing lawmakers, Mwangangi explained that the authority is legally restricted from paying foreign facilities until it completes a formal procurement and contracting process in line with public finance laws.
“SHA can only pay a contracted facility. As SHA stands right now, we have no contracts with any management or treatment facility in India or any other countries,” she stated.
Her clarification comes amid growing anxiety among contributors who expected the newly established health insurance framework to facilitate access to specialised care abroad, particularly for complex procedures not available locally.
Mwangangi noted that the transition from the defunct National Hospital Insurance Fund (NHIF) to SHA introduced stricter compliance requirements. Under NHIF, overseas hospitals were engaged through a guarantee-of-payment model, which allowed patients to seek treatment once approval was issued.
However, SHA is bound by public procurement regulations before entering into agreements with foreign institutions.
“NHIF had a different methodology of contracting hospitals abroad. They issued what was known as a guarantee of payment to a certain number of hospitals before. Now we have to follow the procurement process in accordance with the law,” Mwangangi told the committee.
She emphasised that adherence to procurement procedures is intended to enhance accountability and protect public funds from misuse.
“The move to follow the procurement process is to prevent fraudulent claims and to prevent hospitals from demanding payments for services they have not offered,” she added.
According to the CEO, negotiations with hospitals in various countries are already underway. The contracting process is expected to be finalised by the end of March 2026.
“When we complete the procurement process, we will publish the names of those facilities, whether in India, Turkey or Germany, with which SHA has contracted and has agreements with,” she said.
India has historically been a primary destination for Kenyans seeking advanced procedures such as cancer treatment, organ transplants and specialised surgeries. However, Mwangangi indicated that the government is expanding its engagement to include multiple countries to broaden options for patients.
Once operational, the overseas treatment package will allow eligible beneficiaries to access up to Ksh 500,000 to cover medical expenses abroad.
The issue of overseas referrals had previously been addressed by Health Cabinet Secretary Aden Duale in 2025, when he suspended the process under SHA pending the introduction of new regulations aimed at tightening oversight.
At the time, Duale indicated that the government sought to streamline the referral system to curb abuse and ensure sustainability of the health insurance scheme.
Until the procurement framework is completed and contracts signed, Kenyans requiring treatment outside the country will have to finance their care independently. For many families, especially those dealing with life-threatening or rare conditions, the costs remain prohibitive.
Members of Parliament raised concerns about the financial strain on patients awaiting clarity, urging SHA to expedite the process while maintaining transparency.
As the March 2026 deadline approaches, stakeholders will be watching closely to see whether SHA can balance regulatory compliance with timely access to critical healthcare services
ALSO READ: UDA Dismisses Viral Notice Claiming ICT Director Was Fired
SHA Reveals Why They Cannot Pay for Overseas Treatment Yet
