SHA Household Coverage: Who One Contribution Covers

SHA household coverage works on a household model. You pay once, and your registered dependants use your cover. Most private medical schemes charge a separate premium for each person, which is the main difference.

Paying every month protects you. It protects your spouse and children only after you add them to your Afya Yangu profile and SHA verifies them. This page explains who counts, what the household shares, and what puts the whole household at risk.

Who Is Covered Under SHA Household Coverage?

The Add Dependant menu on Afya Yangu has four options: child, child (adopted), child (loco parentis) and spouse. Each option has its own documents and age rules, so each has its own guide.

Who	When they qualify	Guide
Spouse	Added with proof of marriage. SHA sends an OTP to the spouse’s phone for consent.	Add a spouse
Biological child under 18	Birth certificate number or birth notification reference number.	Child under 18
Biological child 18 and above	The child’s own National ID number. Students need proof of enrolment. Over 25 only with a disability and under your care.	Child above 18
Adopted child	Adoption order, with the same age rules as other children.	Adopted under 18 · above 18
Child under your guardianship	Court document establishing your guardianship, with the same age rules.	Loco parentis under 18 · above 18

To see the login path and every click, use our guide on how to add dependants to SHA. A child who has just turned 18 may be asked to register with their own National ID before you can add them, so do that first if the portal asks.

More than one spouse is not clearly covered in SHA’s published rules. See multiple spouse registration on SHA before you assume either way.

Does SHA Household Coverage Include Parents and Siblings?

Not through the Add Dependant menu. Parents and siblings are not among its four options. Call SHA on 0800 720 601 to ask whether a parent can be linked to your profile.

The safer route is to register the parent as their own member. Someone without a salary is assessed through SHA means testing, and our guide for the unemployed on SHA explains what they pay.

What Does One SHA Contribution Cover?

It covers the contributor and the registered dependants at SHA-contracted facilities. A salaried contributor pays 2.75% of gross monthly pay. Anyone else is assessed on declared income, subject to a minimum. See SHA monthly contribution rates and the SHA minimum contribution.

What the cover pays for is a separate question, answered in our guides to the SHA benefits package and what SHA actually covers. For two common needs, see SHA maternity cover and SHA for kidney dialysis.

Which Limits Does SHA Household Coverage Share Across the Household?

Some SHA limits are counted per household, not per person. Everyone on your profile draws from the same pool.

Benefit	Limit	Counted against
Medical inpatient admission	Up to 180 days a year	Whole household
Optical (eyeglasses)	KES 1,000 a year	Whole household
MRI, CT scan, mammography and echocardiogram	2 per service a year	Whole household
Assistive devices	1 device a year	Whole household
Diabetes, cardiovascular, sickle cell and COPD or asthma packages	Once a year	Each person

A long admission for one family member therefore reduces the days left for the rest of the household. SHA’s claims system checks household and individual balances when treatment is approved.

SHA can change tariffs and limits, so confirm the current figures on sha.go.ke benefit tariffs.

What Happens to SHA Household Coverage If You Stop Paying?

Dependants have no cover of their own. It runs through your membership, so when your contributions lapse, everyone on your profile loses active cover at the same time.

A common trigger is job loss. When an employer stops remitting, the household needs to move to self-paying. Our guide on changing your SHA employment status covers that switch, and SHA cover lapsed explains how to restore cover. If you have paid and the portal disagrees, check whether your SHA payment went through.

Should an Adult Be a Dependant or Register Alone?

An adult with their own income can register with SHA as an independent member instead of sitting on someone else’s profile. That keeps their cover separate, so it does not lapse when the other contributor stops paying. A dependant costs nothing extra, so for a low-income household adding dependants is usually cheaper.

How to Check That Your SHA Household Coverage Is Active

Frequently Asked Questions About SHA Household Coverage

Does one SHA contribution cover my whole family?

No, not automatically. One contribution covers you and the dependants you have added and had verified on your SHA profile. A family member who is not registered is not covered.

Who is covered under SHA household coverage?

The contributor, a spouse, biological children, adopted children and children under legal guardianship, once each is registered and verified. The Add Dependant menu on Afya Yangu offers exactly these four dependant types.

Does SHA cover parents and siblings?

The Add Dependant menu does not list parents or siblings. Ask SHA on 0800 720 601 whether a parent can be linked to your profile, or register the parent as their own member.

What is a household limit on SHA?

It is a benefit cap counted across everyone on your profile rather than per person. SHA sets household limits for medical inpatient days, optical care, some imaging and assistive devices.

What happens to my dependants if I stop paying?

Their cover runs through your membership, so everyone on your profile loses active cover when your contributions lapse. Pay the arrears or switch to self-paying to restore it.

Is there a limit on how many dependants I can add?

SHA does not clearly publish a cap on the number of dependants. Confirm with SHA on 0800 720 601 if you are adding a large household.

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