Photo: Isaiah Maghanga, Wikimedia Commons, CC BY-SA 4.0SHA vs private medical insurance in Kenya
SHA vs private medical insurance in Kenya: what each covers
Short answerChecked 23 September 2026
SHA is the public scheme everyone contributes to (2.75% of income, minimum KES 300 a month, no waiting period once up to date). Private medical insurance is optional: the price depends on the plan, age and family size, and it usually adds a wider hospital network, higher limits and outpatient cover, often with waiting periods and exclusions. Most families use private cover on top of SHA, not instead of it.
Side by side
| SHA | Private medical insurance | |
|---|---|---|
| Compulsory? | Yes — contributions required by the Social Health Insurance Act | No |
| Price | 2.75% of income, min. KES 300/month, no ceiling | Set by the insurer: plan, age, family size, limits |
| Who sells it | The Social Health Authority | Insurers and medical insurance providers licensed by IRA |
| Waiting period | None once contributions are up to date (SHA FAQ) | Usually, for some benefits — read the policy |
| Pre-existing conditions | — | Often excluded or covered after a waiting period |
| Where you are treated | SHA-contracted facilities | The insurer's panel of hospitals |
| If you stop paying | No services until arrears + 2% monthly penalty are paid | The policy lapses |
When a private plan is worth adding
- You want a specific private hospital that is not in SHA's network.
- You need outpatient cover (consultations, medicines) beyond what SHA gives you.
- Your employer pays for a group plan — then compare it with what SHA already covers.
Compare plans with our health insurance checklist and check the provider on the IRA registry.
What would you like to do now?
Frequently asked questions
Do I still need SHA if I have private medical insurance?
Yes. SHA contributions are required by law; a private plan is an addition, not a replacement.
Is private medical insurance better than SHA?
Neither is better in general: SHA is the base everyone pays; a private plan can add hospitals, limits and outpatient cover for a price. Compare what you actually need.