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Insurance & Social Health Authority (SHA)

We partner with major insurers and Kenya’s SHA to make quality care accessible. Learn how to use your cover, what to bring, and how pre-authorization works.

Accepted Insurers How to Use Your Cover

Coverage at Nazareth Hospital

Simple steps to confirm your benefits and avoid delays at the point of care.

1
Verify Eligibility

Bring a valid national ID/passport, your insurance card, and a referral letter if required by your scheme.

2
Pre-Authorization

Some services (admissions, surgery, advanced imaging, oncology) need prior approval. We’ll assist with submission.

3
Co-pays & Limits

Your benefit plan may require a co-pay or have annual limits. Settle any balances not covered by your insurer.

4
Claims Support

Our billing team guides you through forms, invoices, and follow-ups to ensure smooth claims processing.

Tip: For faster approvals, arrive with referral notes, prior reports, and your insurer’s authorization hotline or email.
Key Documents to Bring
  • National ID/Passport (original)
  • Insurance card/Smart card (valid & active)
  • Referral letter (if your plan requires it)
  • Pre-authorization letter/code for admissions or high-cost procedures
  • Previous medical reports, imaging, or prescriptions
Contacts — Patient Accounts

Tel: +254 709 667 000
Email: accounts@nazarethhospital.or.ke

Accepted Insurers & Schemes

See FAQs
Note: Insurer panels and benefits may change. Confirm your cover with your provider or our Patient Accounts team before your visit.

How to Use Your Insurance or SHA Cover

Follow these steps for outpatient, inpatient, and specialized services.

  • Present your ID and insurance card at Registration.
  • Our team validates your eligibility and benefit limits.
  • Some tests or imaging may require real-time approval; we’ll assist.
  • Co-pays (if applicable) are paid at the Cashier before service.

  1. Get an admission/surgery request from your attending doctor.
  2. Provide required documents: ID, insurance card, referral, clinical notes.
  3. Our team submits to your insurer/SHA for pre-authorization.
  4. Once approved, we schedule admission and brief you on any exclusions.
  5. Uncovered items (e.g., some consumables) are paid by the patient/guarantor.

Oncology benefits vary by plan. To prevent delays, bring:

  • Pathology report, staging/oncologist notes, and proposed regimen
  • Previous approvals and claims statements (if under active treatment)
  • Insurer contact for oncology pre-authorizations
Common Co-Pays & Out-of-Pocket
Service Typical Patient Share*
General ConsultationKSh 200 – 1,000
Specialist ConsultationKSh 500 – 2,000
Basic Lab PanelsKSh 0 – 1,500
X-ray / UltrasoundKSh 500 – 2,500
CT / MRI (with approval)Varies by plan
Admission (Ward)Varies by plan & room

*Illustrative ranges. Your exact amount depends on your plan benefits, limits, and exclusions.

Downloadable Forms

SHA (Social Health Authority) — Quick Guide

Using your national health cover at Nazareth Hospital.

A
Eligibility & Registration

Ensure your SHA account is active and you’re listed under your household facility preferences if applicable.

B
Referral Pathways

Some services require referral from a primary facility—bring the referral letter/codes when you come.

C
Co-Payments

Certain services may require standardized co-payments. Our cashiers will guide you where applicable.

Reminder: Always carry your ID and active SHA credentials. For the latest policy updates, consult SHA communications or call our team for assistance.

Frequently Asked Questions

We can often set up a case-by-case arrangement or treat you as a cash patient while you seek reimbursement. Talk to our Patient Accounts team for guidance.

Timelines vary by insurer and service complexity. Straightforward approvals may be same-day; others can take longer. Bringing complete documentation speeds this up.

Exclusions depend on your policy; common examples include some non-formulary drugs, personal items, private rooms without indication, and take-home supplies. We’ll advise in advance where possible.

Yes. If your benefits are exhausted or an item is excluded, you can top-up by cash, card, or mobile money at the Cashier.
WA ☎