Universal Health Insurance Act Tanzania 2023: what it says

Short answerChecked 31 October 2026

Tanzania's Universal Health Insurance Act, No. 13 of 2023, sets up a system in which every resident of Mainland Tanzania gets health care through insurance without a financial barrier. Most of it came into force on 16 August 2024 (GN No. 700A), but section 5, which makes health insurance compulsory for everyone, was left out, together with the late-joining surcharge (section 37). Implementation began on 26 January 2026 with poor households whose cover the Government pays.

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On this page · 9 sections

What the Act is and where it applies
Which sections are in force, and which are not
The three benefit packages
Poor households: who pays, and where it stands in 2026
Members, dependants and employers
Complaints and penalties
Related guides
FAQ
Sources

What the Act is and where it applies

Passed by Parliament on 1 November 2023, assented to by the President on 19 November 2023, published as Act No. 13 of 2023 (Act). NHIF now cites it as Cap. 161 (NHIF).
It applies to Mainland Tanzania (section 2). Zanzibar has its own fund: ZHSF.
Its objects are access to quality health services for all through health insurance, and a framework for every citizen and resident to take part (section 4).
The regulator of health insurance services is the Tanzania Insurance Regulatory Authority (TIRA): it registers schemes, makes sure they provide the essential benefit package and keeps a database of contracted facilities (section 7).
NHIF is recognised as the public health insurance scheme (section 8); licensed private health insurers continue as private schemes (section 9).

Which sections are in force, and which are not

By Government Notice No. 700A of 14 August 2024, the Minister of Health set 16 August 2024 as the date the whole Act came into force except these sections:

Section left out	What it says
5	Health insurance is compulsory for everyone; every employer contributes for its employees; foreigners aged 18+ staying more than 30 days without recognised cover must join
37	Anyone who has not joined within three years of commencement pays a surcharge of 10% of the contribution for each year
43	Transitional provisions
58–61	Amendments to the National Social Security Fund Act, Cap. 50
62–63	Amendments to the Law of the Child Act: a parent or guardian registers the child in a health insurance scheme
64–65	Amendments to the Employment and Labour Relations Act: the employer registers the employee, and failing to do so is an offence

So, until a new notice is published, the Act does not make insurance compulsory for every person and charges no surcharge for joining late. Other sections are in force, including section 22: public-sector and formal private-sector employers must register each employee within 30 days of the start of the employment contract (Act).

The three benefit packages

Package	For whom	Services (Schedule to the Act)
Essential benefit package (sections 13–14)	Every member or beneficiary of any health insurance scheme, as the minimum; it lasts one year from registration	Registration and consultation; laboratory, radiology and imaging tests; admission; medicines on the National Essential Medicines List; eye, oral and dental care; delivery; surgery; specialised and super-specialised services — from dispensary to national hospital
Community health insurance package (sections 15–17)	A person with no other cover under the Act; provided by the public scheme	The same basic services, from consultation to surgery, without the specialised services
Supplementary package (section 18)	Anyone who wants more than the essential package	Set by each scheme, under TIRA's guidelines

The Minister can change the lists by Order in the Gazette (sections 14(4) and 15(4)). Services follow the referral system at facilities contracted by the scheme (section 21). NHIF's own packages and prices: NHIF packages 2026.

Poor households: who pays, and where it stands in 2026

The Minister, with the relevant authorities, sets how poor people are identified, and those identified are entitled to be enrolled (section 24). Their database is kept by the Ministry and reviewed every three years (UHI Regulations 2024, reg. 14).
Section 25 sets up a fund for the health insurance of the poor, which may be financed from electronic transactions, excise duty on carbonated drinks, alcohol and cosmetics, gaming tax, a levy on motor vehicle insurance and money voted by Parliament.
Enrolled people are treated at public facilities or at private facilities contracted by the Government (reg. 16(3)).
The essential package started on 26 January 2026 for the group the Government pays for. Its cost is TZS 150,000 per household of up to 6 people (NHIF, 23 January 2026).
By June 2026, 276,004 households (100% of those targeted in the first phase) were registered, and 997,015 beneficiaries out of 1,206,319 targeted (83%). 501,981 beneficiaries had not yet collected their cards; the Government reaches them through District Executive Directors' offices and community health workers (NHIF, 12 August 2026).

Members, dependants and employers

Members include people who were members of a scheme before the Act, private and public employees, the self-employed and the poor (section 19). A person in the formal private or informal sector may join any scheme.
Beneficiaries: a member may register a spouse and up to four dependants (section 20). A dependant is a parent of the member or of the spouse, or a biological, adopted or step child, or a blood relative, under 21 (section 3).
A formal private-sector employer contracts one scheme for its employees, involving them in the choice, and remits contributions on or before the 15th of the following month (reg. 23). In the public scheme the employer pays half or more of the contribution (reg. 31).
The waiting period may not exceed 30 days, and does not apply to employees or to poor people paid for by the Government (reg. 22).
If a member who pays yearly dies, the dependants keep receiving services for the rest of the membership term (section 28(3)).

Sources: Act, Universal Health Insurance Regulations, 2024. How to register: NHIF registration and the NHIF portal.

Complaints and penalties

Complaints and disputes between a scheme, a facility, a beneficiary or an employer are handled under the Insurance Act's procedure (section 34). The Act also added section 124(5) to the Insurance Act: the Insurance Ombudsman has no monetary limit for health insurance complaints referred by TIRA (section 56).
False information (section 36): for a member or beneficiary, a fine of TZS 500,000 to 5 million, 6 to 12 months' imprisonment, or both; for a scheme, a fine of TZS 10 to 100 million; for a facility, TZS 5 to 50 million. TIRA may also suspend a scheme or facility for up to two years.
Other offences with no specific penalty (section 39): for an individual, a fine of TZS 500,000 to 5 million or 6 months to 2 years in prison, or both; for a company or body, TZS 10 to 100 million.

Source: Universal Health Insurance Act. How to complain about an insurer: insurance complaints in Tanzania.

Related guides

The whole picture — NHIF rates, universal cover, ZHSF and private plans: health insurance in Tanzania. The same guide in Kiswahili: Sheria ya Bima ya Afya kwa Wote.

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Frequently asked questions

Is health insurance compulsory in Tanzania now?

Not yet. Section 5, which makes it compulsory for everyone, was left out by GN No. 700A of 2024, which brought the rest of the Act into force on 16 August 2024.

Does the Universal Health Insurance Act apply in Zanzibar?

No. Section 2 limits it to Mainland Tanzania. Zanzibar has the Zanzibar Health Services Fund (ZHSF).

What does the essential benefit package cover?

Registration and consultation, tests, admission, medicines on the National Essential Medicines List, eye, oral and dental care, delivery, surgery, and specialised and super-specialised services (Schedule, Part A).

Who pays for the health insurance of poor households?

The Government, through the fund for the poor (section 25). The first phase started on 26 January 2026, and 276,004 households were registered by June 2026.

Will I pay a penalty for joining health insurance late?

Not for now. Section 37 (a 10% surcharge for each year) is not in force.

What must employers do under the Act?

Register each employee with a health insurance scheme within 30 days of the start of the contract (section 22) and remit contributions on or before the 15th of the following month (reg. 23).