SHA Overseas Treatment Approval: Ouma Olunga Announces Strict New Rules for Kenyans Seeking Medical Care Abroad
The government has tightened the SHA overseas treatment approval process, with State Department for Medical Services Principal Secretary Ouma Olunga outlining new requirements that Kenyans must meet before travelling abroad for medical care.
Speaking during a press briefing on Thursday, February 19, Olunga said patients will now be required to obtain confirmation from at least two doctors stating that their condition cannot be treated locally before they can be cleared to seek treatment outside the country.
Two-Doctor Confirmation Now Mandatory
According to the PS, the new framework is designed to create accountability and ensure that only deserving cases receive support from the Social Health Authority (SHA).
“What we have done is to ensure that for all Kenyans who are going for treatment overseas, we have a clear mechanism for registering to make sure that at least two doctors have seen you and write a report that your treatment cannot be done here,” Olunga stated.
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Once the two doctors confirm that the treatment is unavailable in Kenya, a formal letter will be submitted to SHA for approval. Only after the authority issues a green light will the patient be eligible to travel under the government-backed arrangement.
Olunga further advised that patients should only seek care from overseas hospitals that have been contracted by SHA to avoid complications.
List of Conditions Already Gazetted
The PS noted that the Health Cabinet Secretary has already published a list of medical conditions that cannot currently be treated in Kenya. If a patient is diagnosed with any of the listed conditions, SHA will process their application accordingly.
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“The Health CS has already gazetted all conditions that cannot be treated here, so if you are diagnosed with such a condition in that list, we will write a letter so that the Social Health Authority supports it,” he added.
In a Gazette Notice dated September 19, Health Cabinet Secretary Aden Duale published 36 specialised medical services that are unavailable locally. Most of these involve highly specialised joint and limb replacement procedures, which require advanced facilities and training that are not yet fully established in Kenya.
Financial Cap for Overseas Treatment
Duale clarified that the maximum amount payable for overseas treatment is capped at Ksh500,000 to ensure value for money and quality care.
“The maximum limit payable for overseas treatment is capped at Ksh500,000, ensuring value for money and quality care,” Duale said.
He added that while an earlier indication suggested patients would access up to Ksh50,000, the cap has since been adjusted to Ksh500,000, depending on contractual arrangements with healthcare providers abroad.
Warning Against Brokers and Informal Arrangements
Olunga also raised concerns about some doctors allegedly encouraging patients to seek treatment abroad even when services are available locally. He warned that such practices expose patients to financial risk and create confusion when payments are delayed or disputed.
“There are some conditions that can be treated here, but some doctors entice them to travel abroad, and when they get stuck there, they start saying the government is not paying. We want to deal with that to ensure that those who go are those who deserve it,” he said.
In a separate notice, SHA urged patients to ensure their contributions are up to date before travelling. The authority cautioned against relying on brokers or assuming automatic government coverage.
“Kenyans should not travel assuming that their treatments will be automatically covered or rely on brokers or informal arrangements for overseas treatment,” SHA warned.
Post-Treatment Support on Return
Olunga assured that once patients complete treatment abroad, SHA will support their recovery process upon returning to Kenya. The authority will coordinate follow-up care locally to guarantee full recovery and continuity of treatment.
The new measures are part of broader reforms aimed at strengthening oversight within the health financing system and preventing misuse of public funds.
Kenyans planning to seek medical treatment abroad are therefore advised to consult qualified doctors, verify that their condition appears on the gazetted list, ensure their SHA contributions are current, and obtain formal approval before making travel arrangements.
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SHA Overseas Treatment Approval: Ouma Olunga Announces Strict New Rules for Kenyans Seeking Medical Care Abroad
