SHA Health Insurance in Kenya, Explained: SHIF Rates, Registration and What's Covered (2026)

If your payslip changed and you're not sure why, or you've heard "NHIF is finished" and want to know what replaced it, this is the guide. The Social Health Authority (SHA) — and the Social Health Insurance Fund (SHIF) contribution that funds it — replaced NHIF from October 2024, and the change is bigger than a rebrand. This explains exactly what you now pay, what it buys you, and how to register if you're self-employed or informal.

What actually happened to NHIF

NHIF was a flat-rate, tiered scheme: your contribution depended on which income band you fell into, and higher earners were, in relative terms, undertaxed for healthcare. SHA replaced it with a proportional contribution — a straight percentage of income, with no ceiling.

That single design change is why the numbers look so different from what you remember. Under the old NHIF bands, someone earning KES 100,000 a month paid around KES 1,700. Under SHIF, that same salary is charged 2.75% — KES 2,750. Someone earning KES 1,000,000 a month now pays KES 27,500, whereas the old flat-banded system would never have asked for anything close to that. The scheme is now genuinely proportional to income, for better or worse depending on where you sit on the payslip.

How much SHIF actually costs

The rate is simple, even if the amount feels new:

• 2.75% of gross monthly pay, for salaried employees.
• No upper cap — unlike NSSF, which stops adding once your pensionable pay passes a ceiling, SHIF keeps taking 2.75% no matter how high your salary goes.
• A KES 300 minimum, which matters mainly for the self-employed and informal-sector members whose declared income is low.

If you're salaried, this is deducted automatically. Your employer withholds 2.75% of your gross pay and must remit it to SHA by the 9th of the following month. There's no employer-matched contribution here the way there is with NSSF — the full 2.75% is yours; the employer's job is only to deduct and remit it correctly.

If you want to see exactly how SHIF interacts with your other statutory deductions and what actually lands in your account, use our net-pay calculator — SHIF, NSSF and the Affordable Housing Levy are all modelled against the current KRA rules, so you can see the whole payslip in one place rather than guessing at one line.

The three funds — and what each one actually pays for

This is the part most explainers skip, and it's the part that decides whether SHA is useful to you in practice. Your contribution doesn't go into one pot — it's split across three distinct funds, each with a different job:

1. The Primary Healthcare Fund (PHF)

Covers everyday outpatient care — clinic visits, basic consultations, the things you'd previously have paid cash for or claimed against NHIF's outpatient benefit. It's funded at a flat KES 900 per person, per year, which is a government top-up rather than something drawn from your 2.75% directly.

2. The Social Health Insurance Fund (SHIF)

The main event, and the one your monthly 2.75% actually funds. It covers inpatient care, surgery, dialysis and maternity at Level 4 to Level 6 hospitals — the mid-to-large public and accredited private facilities. This is your protection against the costs that actually bankrupt Kenyan households: an admission, an operation, a delivery.

3. The Emergency, Chronic and Critical Illness Fund (ECCIF)

The safety net behind the safety net. Once SHIF's own annual limits are exhausted, ECCIF tops up cover for the catastrophic cases — ICU admission, ambulance evacuation, cancer treatment — that would otherwise mean a family selling land or borrowing heavily to keep someone alive. This fund is precisely why SHA is structured as three layers rather than one: routine care, serious care, and catastrophic care each have their own budget so one doesn't crowd out the others.

Benefit limits, facility accreditation lists and exact tariffs change as the scheme matures — always confirm current cover levels directly with SHA (sha.go.ke) before relying on a specific benefit figure for a real medical decision.

Registering for SHA

Every Kenyan needs to be registered — this isn't optional the way some private cover is. The process differs slightly depending on your employment status.

If you're salaried

Registration typically happens through your employer as part of standard HR onboarding, since your contribution is already being deducted from payroll. If you've never actively registered, do it yourself using the steps below — an employer's payroll deduction doesn't always mean SHA has your full member profile, including dependants.

If you're self-employed or in the informal sector

This is where most of the confusion sits, because there's no employer to handle it for you. The process:

1. Dial *147# on your phone. This launches SHA's registration menu.
2. Enter your national ID number. The system verifies your name against the government's IPRS database — so make sure the ID you're using is the one your other records are tied to.
3. Select your employment status — Self-Employed is the correct choice for boda boda riders, small traders, artisans (fundis) and anyone without a formal payroll. Other categories include Unemployed, Student and Retired.
4. Set up your account with your phone number and a confidential PIN.
5. Add your dependants — spouse and children who'll be covered under your membership.
6. Complete means testing. SHA asks about your income, household and assets to work out what you should contribute. Answer accurately — this is what sets your monthly amount, subject to the KES 300 floor.

You can also register online at SHA's website, or in person at a Huduma Centre or SHA branch office if you'd rather not do it by phone.

How to pay if you're self-employed

Once registered, informal-sector members pay via M-Pesa Paybill 200222, using your national ID number as the account number. Set a monthly reminder — payments that lapse can affect your active cover status, and (per recent SHA communication) late payment for informal-sector members may attract a 2% penalty.

That penalty figure comes from SHA's own public messaging as at early August 2026, not yet from a figure we've traced to a gazetted regulation — treat it as the current administrative position and confirm directly with SHA before assuming it applies to your specific case.

SHA vs private medical insurance — different jobs, not competitors

A common question is whether SHA replaces the need for private cover. It doesn't, and understanding why helps you plan properly.

SHA is universal, mandatory and baseline — everyone pays in (proportional to income), and everyone is covered for the tiers described above. It is not designed to give you a private room, a choice of specialist, or fast-tracked elective procedures. Private medical insurance sits on top of SHA for people who want that — many private policies are explicitly priced and structured as a SHA-plus product, assuming SHA handles the base layer and the private policy covers the gap (better facilities, shorter waits, wider specialist networks, sometimes outpatient limits SHA doesn't reach).

For most households the sensible order is: register and stay current with SHA first (it's mandatory, and the ECCIF layer specifically protects against the catastrophic costs that ruin finances), then add private cover if your budget allows and you want the comfort and speed private facilities offer. Treat SHA as the floor everyone stands on, not the whole building.

Common problems people run into

"My employer says they're deducting SHIF but I can't find myself registered." Payroll deduction and full member registration are two different systems that don't always sync automatically, especially soon after a scheme change like this one. Dial *147# and check your own status directly rather than assuming HR has handled everything.

"I changed jobs and my cover looks different." Because contributions are proportional to your current salary, moving employers — or moving from salaried work to self-employment — changes your monthly SHIF amount immediately. There's no portability issue with the cover itself, but the amount you owe each month will follow your new income.

"I'm being asked to pay a penalty I didn't expect." This is most likely to catch informal-sector members whose payment lapsed. Confirm the exact amount and reason directly with SHA — don't pay anyone claiming to "waive" a penalty for a fee, which is the same scam pattern that targets people trying to clear a CRB listing (see how to check your credit score in Kenya for how that scam works elsewhere in the financial system — the principle is identical: nobody legitimate charges a fee to fix your own record).

"I don't know if my hospital is accredited." Ask the facility directly before admission wherever possible, or check with SHA — accreditation lists are updated as the scheme rolls out further, so a hospital that wasn't accredited at launch may be now, or vice versa.

What this means if you're switching jobs or going self-employed

Because SHIF is now proportional rather than banded, the amount you pay moves in lockstep with your income — a pay rise means a bigger SHIF deduction, and a move from salaried work into self-employment means you go from automatic payroll deduction to being personally responsible for paying via Paybill every month.

If you're planning that move, budget for it the way you would any other fixed monthly cost — see how to budget on a Kenyan salary for the general framework, and remember that unlike NSSF or a SACCO contribution, SHIF isn't a form of savings you get back. It's insurance: money that funds cover for you and everyone else in the scheme, not a balance that accrues in your name.

Frequently asked questions

Is SHA the same as NHIF? No — SHA is the authority, and SHIF is the proportional 2.75%-of-income contribution that replaced NHIF's old banded rates, effective October 2024. The benefits, funding structure and contribution method are all different from the old scheme.

How much do I pay if I'm self-employed? At minimum KES 300 a month, rising according to means testing based on your declared income, household and assets. There is no fixed percentage quoted for the informal sector the way there is for salaried employees — it's assessed individually.

Do I need to register if my employer already deducts SHIF from my payslip? Payroll deduction and full SHA registration (including your dependants) aren't automatically the same thing. Confirm your registration status and add your dependants yourself if you haven't already — you can check your status via the *147# menu.

What happens if I don't pay? Contributions lapsing can affect your active cover, and SHA has signalled a 2% penalty for late informal-sector payments as of mid-2026 communications. Confirm the current enforcement position directly with SHA, since this area has moved since the scheme launched.

Does SHIF cover private hospitals? Cover applies at accredited facilities across public and private providers, concentrated at Level 4–6 institutions for the main SHIF benefit. Confirm whether your specific hospital is accredited before assuming a bill will be covered.

Is there a cap on how much SHIF I pay? No — unlike NSSF, which stops accruing once your pensionable pay crosses its ceiling, SHIF's 2.75% applies to the whole of your gross pay with no upper limit.