Govt announces overseas treatment scheme for Kenyans under SHA

The government has launched a new framework under the Social Health Authority (SHA) to help Kenyans access specialised medical treatment abroad.

In a notice published by Cabinet Secretary Aden Duale on Saturday, September 20, 2025, the ministry said the scheme is meant to ensure no patient is denied life-saving procedures that are not yet available in Kenya, while strengthening the local health system.

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Under the new framework, Kenyans eligible for overseas treatment must have their SHI contributions up to date.

Access is limited to procedures unavailable in local hospitals, and overseas facilities must be accredited in their home countries and linked to a Kenyan hospital for follow-up care.

“This framework guarantees a transparent, evidence-based, and accountable system for Kenyans seeking treatment abroad,” Duale said.

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Referrals will be reviewed by the Claims Management Office to ensure medical necessity and compliance with financial limits.

The government has set a maximum cover of Ksh 500,000 per patient, though this may be adjusted as contracts with overseas providers are finalised.

“The maximum limit payable for overseas treatment is capped at Ksh500,000, ensuring value for money and quality care,” Duale noted.

Services and coverage

The Benefits Package and Tariffs Advisory Panel has gazetted an initial list of 36 specialised procedures eligible for overseas treatment, with plans to expand the list based on ongoing Health Technology Assessments.

Duale explained that only SHA-contracted facilities abroad will be used to prevent unregulated care and ensure continuity when patients return home.

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The ministry emphasised that the new system is both a safety net and a quality assurance measure.

“No Kenyan should be denied life-saving care due to local limitations or personal cost,” officials said.

The framework also aims to improve local services by integrating overseas care with domestic follow-up, giving patients access to advanced treatment while supporting the national health system.