Payments & insurance
Payments & insurance
Primegala accepts SHA for eligible services, M-Pesa and cash. Before treatment, our front desk checks your SHA eligibility with your national ID and explains what is covered and any cost to you.
Ways to pay
How you can pay at Primegala
SHA
M-Pesa
Cash
Private insurance
Clear costs
We explain costs before treatment
No one should be surprised by a bill. Before any treatment, we tell you what SHA or your insurer covers and what, if anything, you will need to pay.
If your care plan changes, for example if you need a test or admission, we explain the cover and cost again before going ahead. You can always ask questions about any charge.
- 1
Registration and eligibility check
Show your national ID (or your child's birth certificate). We check your SHA status in the national system. - 2
We explain your cover
What SHA or your insurer pays for this visit, and any part that is not covered. - 3
You decide
You agree to the plan and any cost before treatment begins, unless it is an emergency. - 4
Pay and keep your receipt
Pay any balance by M-Pesa or cash and ask for a receipt.
Social Health Authority (SHA)
Using SHA at Primegala
SHA replaced NHIF in October 2024. It pays for care through three funds. Benefit rules and tariffs are set by SHA and can change, so we always confirm yours.
At the front desk
- Bring your national ID. We use it to check your eligibility in the national system.
- Keep the phone registered with SHA with you. A one-time code (OTP) may be sent to it to verify your visit.
- Not registered yet? Dial *147# on any phone, or ask our front desk to help you.
- Children must be registered as dependants of a parent or guardian to be covered.
The three SHA funds
Primary Healthcare Fund (PHCF)
Outpatient consultations, basic tests, antenatal care, family planning, child health and other primary care at Level 2 and 3 facilities like ours.
Social Health Insurance Fund (SHIF)
Inpatient care and admissions, for members whose contributions are up to date.
Emergency, Chronic and Critical Illness Fund (ECCIF)
Emergency care and stabilisation, and chronic or critical illness beyond SHIF limits.
Good to know
M-Pesa, cash, insurance and receipts
Paying by M-Pesa
Pay at the front desk and our team will give you the payment details. Only pay to the details given to you at our front desk, and keep the M-Pesa confirmation message until you have your receipt.
Private insurance
Ask our front desk which private insurance schemes we currently accept before your visit or on arrival. Bring your insurance card and ID. Some insurers need approval (pre-authorisation) before certain services, so tell us about your cover early.
Receipts
Ask for a receipt for every payment. Keep receipts with your M-Pesa messages: you may need them for an insurance claim, an employer, or if you have a question about a bill.
Questions about a bill
Speak to the front desk at any time, or email info@primegala.co.ke or call 0746 100 727. If you are not satisfied, use our complaints procedure.
Emergency treatment is your right
Under Article 43(2) of the Constitution of Kenya, no one may be denied emergency medical treatment. In an emergency we assess and stabilise first, and deal with SHA or payment afterwards. SHA's Emergency, Chronic and Critical Illness Fund (ECCIF) supports emergency care for registered members.
FAQs
Payment questions
Does Primegala Medical Centre accept SHA?
Yes. Primegala accepts the Social Health Authority (SHA) for eligible services. Bring your national ID and the phone registered with SHA so our front desk can confirm your eligibility before treatment.
Can I pay with M-Pesa at Primegala?
Yes. You can pay by M-Pesa or in cash at the front desk. Ask the front desk for our payment details and keep your M-Pesa confirmation message.
Which insurance does Primegala accept?
Primegala accepts SHA for eligible services. For private insurance, please ask our front desk which schemes we currently accept, and bring your insurance card and ID.
Will I know the cost before I am treated?
Yes. Before treatment we explain what SHA or your insurer covers and any cost to you. If your care plan changes, we explain again before going ahead.
Can I be refused emergency treatment if I cannot pay?
No. Under Article 43(2) of the Constitution of Kenya, no one may be denied emergency medical treatment. In an emergency we assess and stabilise first.
Will I get a receipt?
Yes. Ask for a receipt for every payment, and keep it with your M-Pesa confirmation message in case you need to make a claim or raise a query.
Questions about cost or cover?
Ask us before your visit or when you arrive. Our front desk is open 24 hours and will explain what SHA covers and any cost to you, before treatment.