Dodoma. The National Health Insurance Fund (NHIF) has unveiled changes to health insurance plans in a bid to make services more accessible to individuals and families.

Health Minister Jenista Mhagama announced the changes on Tuesday, introducing two packages named Ngorongoro Afya and Serengeti Afya, while ending the Najali, Timiza and Wekeza programs.

She said the Ngorongoro Afya package provides 445 services, with annual contributions starting at Sh240,000 per beneficiary, while Serengeti Afya covers 1,815 services, with contributions starting at Sh660,000 per year.

For children, the Toto Afya Kadi plan offers flexible options based on the method of registration. For group registration, the annual contribution is Sh50,400 per child, while for individual registration, the cost is Sh150,000 per child per year.

The children’s package is divided into three levels depending on the premiums.

The first tier requires contributions worth Sh658,000 per year, with an inpatient limit of Sh22 million and an outpatient limit of Sh3 million.

The second tier costs Sh237,000 per year, with inpatient cover of up to Sh8 million and an outpatient limit of Sh2 million.

The third tier involves contributions of Sh150,000 per child per year, covering up to Sh2 million for inpatient services and Sh1 million for outpatient treatment.

Speaking at the launch of the packages, Ms Mhagama called on the NHIF to engage all relevant stakeholders to ensure the new packages align with Universal Health Coverage (UHC) goals and address public concerns .

“We need to ensure that all key stakeholders are involved to gather feedback from various groups. This will help us design programs that meet the needs of citizens and strengthen the health sector,” she said.

She acknowledged past challenges the NHIF has faced, including service delays, late payments and fraud. She said she was confident the new systems would resolve the problems and restore public confidence in the fund.

“I urge the NHIF to continually improve its systems to reflect current realities, strengthen monitoring and ensure that members receive quality services as expected,” she added.

She further warned against collusion between NHIF staff and service providers, promising stern action against those engaged in fraudulent activities.

Highlighting the role of technology, Ms Mhagama noted that the NHIF’s new digital systems are designed to eliminate inefficiencies in claims processing and fraud detection.

“Systems must foster an environment conducive to universal health coverage. All stakeholders should collaborate to refine the packages and address concerns,” she said.

NHIF Managing Director Irene Isaka revealed that the new systems were developed by local experts at a cost of Sh445 million, a saving of Sh3.5 billion compared to outsourcing. She added that members can now register online, pay their dues via mobile platforms and monitor their card usage in real time.

“For example, a child insured for Sh50,400 can access services worth Sh400,000. Parents will also receive updates on the remaining balance via SMS,” she explained.

The claims processing system has been significantly improved, reducing the processing time of 1,000 claims to 40 minutes, compared to the previous capacity of 800 claims per day.

The Chairman of the Parliamentary Standing Committee on Health and AIDS, Mr Elibariki Kingu, has urged the NHIF to address late payments to service providers, which have disrupted hospital operations and delayed staff salaries.

“The adjustments should ensure that costs meet the needs of private and public hospitals,” he said.

The representative of the Tanzania Insurance Regulatory Authority (TIRA), Mr. Edgar Gabriel, commended the NHIF for introducing measures to combat fraud and improve service delivery.