What Social Health Authority covers — in plain language. No medical jargon.
🔍 Check your personal SHA status
To verify your own SHA registration and check your specific benefits, use the official SHA channels:
🌐
Website
sha.go.ke
→
📞
Call centre
0800 720 601 (toll free)
📱
USSD
Dial *147# on Safaricom
🏥
In person
Visit any SHA-accredited hospital
Find SHA-accredited hospitals near you
See which hospitals accept your SHA cover
What SHA covers
Full breakdown of services, limits and conditions — updated 2025
⚠️
Figures are approximate — always verify before treatment
SHA benefit limits are updated periodically. These figures are based on 2024–2025 data. Always confirm with your hospital or visit sha.go.ke before receiving treatment.
🏥 Outpatient services
✓
General consultation
At any SHA-accredited facility
KES 1,000 per visit
✓
Specialist consultation
Requires referral from GP
KES 2,500 per visit
✓
Medicines (outpatient)
Only on KEMSA approved list
As prescribed
✓
Dental (basic)
Extractions and fillings only
KES 3,000 per year
✗
Optical
Not covered under SHA
—
🏨 Inpatient / Surgery
✓
General ward admission
Up to 180 days per year
KES 5,000 per day
✓
Surgery (elective)
At accredited hospitals only
KES 100,000 per year
✓
ICU / High dependency
Up to 14 days per admission
KES 15,000 per day
✓
Anesthesia
Covered as part of surgical package
Included in surgery
✗
Private room
General ward only
—
👶 Maternity
✓
Antenatal care (8 visits)
At any SHA facility
Fully covered
✓
Normal delivery
Including postnatal care
KES 10,000
✓
C-section (emergency)
Emergency only
KES 50,000
✓
Newborn care (7 days)
Covered as part of delivery package
Included
🚑 Emergency
✓
Emergency admission
Any hospital in emergency
Up to KES 100,000
✓
Ambulance
Approved services only
KES 3,000 per trip
✓
Blood transfusion
Up to 3 units per episode
Included in admission
💉 Chronic & specialist
✓
Dialysis (kidney)
Up to 156 sessions per year
KES 12,000 per session
✓
Cancer treatment
Chemotherapy and radiotherapy
KES 250,000 per year
✓
HIV/AIDS treatment
ARVs and monitoring
Fully covered
✓
Mental health
Inpatient and outpatient
KES 40,000 per year
✓
Physiotherapy
Up to 12 sessions per year
KES 1,500 per session
🔬 Diagnostics
✓
Blood tests (basic)
At SHA-accredited labs
KES 500 per test
✓
X-Ray
Standard X-rays only
KES 1,500 per image
✓
Ultrasound
Diagnostic purpose only
KES 2,500 per scan
✓
MRI / CT Scan
Requires pre-authorization
KES 12,000 per scan
✗
Genetic testing
Not covered under SHA
—
⚠️ Note: This information is based on the SHA benefit package as of 2025. Coverage limits and conditions may change. Always confirm with your hospital before receiving treatment. For the most accurate information visit sha.go.ke