# What should we do when an SHA inpatient is close to their benefit limit?

URL: https://tymirahealth.com/resources/faqs/what-should-we-do-when-an-sha-inpatient-is-close-to-their-benefit-limit
For: Finance | Billing and payments | Reviewed by Independent clinical reviewer, Registered mental health clinician, Kenya | Last reviewed 8 November 2026

**Answer:** SHA's contract lists inpatient mental health care within an annual inpatient limit of 180 days. If a beneficiary's limit is used up or about to run out during an admission, notify SHA immediately. Do not discharge them, stop treatment or demand payment until SHA decides whether its Emergency, Chronic and Critical Illness Fund covers the episode. SHA must decide within 24 hours for inpatients; if it does not, care continues and the episode is reconciled later. Track bed days against limits daily.

Sources: Social Health Authority: https://www.sha.go.ke/wp-content/uploads/2026/09/PART-A-Master-General-Terms-Conditions.pdf - Social Health Authority: https://new.sha.go.ke/wp-content/uploads/2026/09/PART-B2-Social-Health-Insurance-Fund-Contract.pdf - Social Health Authority: https://www.sha.go.ke/benefit-tariffs

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