The National Health Insurance Management Authority (NHIMA) is Zambia's mandatory health insurance scheme. Every employed person in Zambia contributes to NHIMA, and in return gains access to healthcare services at accredited facilities across the country.
This guide covers how the scheme works, how contributions are calculated, and how to access your benefits. Use our NHIMA calculator to see the exact contribution for your salary.
What is NHIMA?
NHIMA was established under the National Health Insurance Act No. 2 of 2018 and became operational in 2019. Its objective, under Section 12, is to provide universal access to quality insured health care services. The scheme pools contributions from employees and employers to fund healthcare at accredited facilities.
NHIMA is managed by the National Health Insurance Management Authority, a statutory body under the Ministry of Health. It is separate from NAPSA (which handles pensions) and from private medical aid providers.
How the 1% contribution is calculated
NHIMA contributions are split equally between employee and employer:
Employee contribution: 1% of gross monthly salary
Employer contribution: 1% of the employee's gross monthly salary
Total contribution: 2% of gross salary (split 50/50)
Payment: The employer remits both shares at the end of each month (Section 15)
Unlike NAPSA, which has a ceiling of K1,861.80 per month for employee contributions, NHIMA has no ceiling. The 1% applies to the full gross salary regardless of how much you earn.
Worked example: K15,000 salary
For an employee earning K15,000 gross salary per month:
Employee contribution = K15,000 x 1% = K150/month
Employer contribution = K15,000 x 1% = K150/month
Total monthly contribution = K300
Annual total = K300 x 12 = K3,600Note: The employee's K150 is deducted from their salary. The employer's K150 is an additional cost on top of the salary.
How to register with NHIMA
Under Section 13(3) of the Act, your employer must register you with NHIMA within 30 days of your contract start date. The process works as follows:
Your employer registers with NHIMA as a contributing organisation
The employer submits details of all employees (name, NRC number, contact details)
NHIMA issues each employee a unique health insurance number (Section 19)
You receive a membership card which you present at accredited facilities
Self-employed citizens and established residents must also register under Section 13(5). This can be done through NHIMA offices or designated registration points.
Who is exempt from NHIMA?
Section 16 of the Act exempts certain persons from paying contributions:
Mentally or physically disabled persons who are unable to work
Elderly persons above 65 years of age
Persons classified as poor and vulnerable by the Ministry responsible for social welfare
All other employed persons must contribute regardless of their private medical cover.
How to access benefits
To use your NHIMA benefits:
Visit a NHIMA-accredited health facility
Present your NHIMA card or NHIMA number at reception
Receive treatment - the facility bills NHIMA directly
You do not make any direct payments for covered services
The benefit package covers consultations, diagnostics, inpatient care, maternity services, and prescribed medicines at accredited facilities. Not all services are covered - the Minister may prescribe exclusions under Section 3(2).
Important: Under Section 26, only accredited providers can deliver insured services. However, in an emergency where no accredited facility is accessible, an unaccredited provider may treat you and NHIMA will still pay (Section 26(3)).
Family coverage and portability
Your NHIMA membership covers your family members - registered children, spouse, and dependants (Section 20). Benefits are portable across the country - you can access care at any accredited facility anywhere in Zambia (Section 24).
If a member dies, their family members continue to receive benefits for four months following the death (Section 21). After this period, continuation arrangements are determined by regulations.
What happens if your employer does not remit
Employers are required to deduct and remit NHIMA contributions by the 10th of the month following the pay period. If your employer fails to remit:
It is a criminal offence under Section 53 - employers who fail to pay, evade contributions, or fail to register employees face fines of up to 200,000 penalty units or two years imprisonment
Employees can report non-compliant employers to NHIMA directly
Reports can also be made through the Ministry of Labour
Your entitlement to benefits is not affected by your employer's failure to remit - you are still covered
If you suspect your employer is deducting NHIMA from your salary but not remitting it, this is a serious matter. Contact NHIMA on their toll-free line or visit a NHIMA office.
For a comparison of NHIMA with private medical aid, see NHIMA vs private medical aid in Zambia. For current rates and payslip details, read our NHIMA contribution rate guide.
Frequently asked questions
How do I register with NHIMA?
Registration is done through your employer. When your employer registers with NHIMA, they submit details of all employees. You receive a NHIMA number which you use to access benefits at accredited facilities.
What happens if my employer does not pay NHIMA?
Employers who fail to remit NHIMA contributions face penalties under the National Health Insurance Act. Employees can report non-compliant employers to NHIMA directly or through the Ministry of Labour.
Can I use NHIMA at any hospital?
No. NHIMA benefits can only be accessed at NHIMA-accredited health facilities. Not all hospitals and clinics are accredited. You can check the list of accredited facilities on the NHIMA website or by contacting NHIMA directly.