Does SHA Cover Optical and Glasses? What You Need to Know

"Does SHA cover glasses?"

I get this question every week.

Short answer: SHA covers eye tests for everyone. It pays for glasses only for children under 18, and only up to KES 1,000 per household a year.

Adults: your eye exam is covered, your glasses are not. Not yet, anyway.

Here's exactly what the gazetted SHA tariffs say, and what you'll pay yourself.

Table of Contents

• What SHA Covers for Optical Care
• The Coverage Limits
• How to Get Glasses with SHA
• What's the Real-World Experience?
• Children's Optical Coverage
• Does Optica Accept SHA?
• Where to Go for Optical Care in Nairobi
• Eye Conditions SHA Covers
• Tips to Maximize Your Optical Benefits
• What If You Need Contact Lenses?
• Private Insurance for Better Optical
• The Bottom Line
• Next Steps

What SHA Covers for Optical Care

SHA pays for eye care in two places: the Primary Healthcare Fund for tests and glasses, and the surgical package for eye operations.

Covered:

• Eye health education and counselling
• Eye tests: visual acuity, fundoscopy and visual field analysis
• Glasses for refractive errors (short or long sight), for under-18s only
• Eye surgery like cataract and glaucoma operations, under the surgical package

Not covered:

• Glasses for adults (18 and over)
• Designer frames and lens upgrades
• Contact lenses
• Cosmetic procedures like LASIK

The Coverage Limits

These come straight from the SHA tariff schedule (Legal Notice 56 of 2025, as amended in May 2026):

Read that household line twice. KES 1,000 a year covers the whole family, not each person. Two kids needing glasses in the same year won't both be fully covered.

The glasses rule applies to under-18s "in year one of implementation". The law says it may widen later, depending on use and funding. Until SHA announces that, plan as if adult glasses are on you.

How to Get Glasses with SHA

Step 1: Go to your primary care facility

When you register, SHA maps you to a Primary Care Network. Eye tests and glasses go through the Level 2, 3 and select Level 4 facilities in that network.

Step 2: Get the eye test

The test is covered under outpatient care. You'll get a prescription.

Step 3: Glasses (children only)

If your child needs glasses, ask the facility to dispense them under SHA. SHA pays KES 950. Anything above that, like a nicer frame, you pay.

Step 4: Surgery goes through referral

Cataract or glaucoma surgery needs a referral to a hospital that offers it. That hospital bills SHA under the surgical package.

What's the Real-World Experience?

Let me be honest.

The good:

• Eye tests are covered for everyone
• Cataract and glaucoma surgery have real money behind them
• Children's basic glasses are covered

The not-so-good:

• Adults get no glasses at all under SHA right now
• KES 950 buys a very basic pair
• KES 1,000 a year is shared by the whole household
• You have to use a facility in your Primary Care Network

Adult glasses in Kenya typically cost several thousand shillings and up. Budget for it, or get it through private cover.

Children's Optical Coverage

This is where SHA actually helps.

• Eye tests at your primary care facility
• Glasses dispensed for refractive errors, KES 950
• Squint surgery at KES 134,400 if a specialist recommends it

If your child struggles to read the board at school, start with an eye test at your primary care facility.

Does Optica Accept SHA?

This is one of the most searched questions about SHA eyewear.

SHA does not pay optical shops directly as a chain. It pays contracted facilities, and glasses go through primary care facilities at KES 950, for under-18s.

So the real question is whether a specific branch is contracted, and for what. Check the SHA contracted facilities list and call the branch before you go. If you're an adult, expect to pay for the glasses yourself either way.

Where to Go for Optical Care in Nairobi

Public options (lower cost, longer wait):

• Kenyatta National Hospital Eye Unit
• Mbagathi Hospital Eye Clinic
• Mama Lucy Kibaki Hospital

Private options:

• Private eye hospitals and optical shops, if they're contracted for the service you need

Call ahead to confirm SHA acceptance for the exact service. Contracts change.

Eye Conditions SHA Covers

Surgical cover has household limits: 3 minor, 2 major and 1 specialised procedure per household per year.

Tips to Maximize Your Optical Benefits

1. Get the test through SHA, always Even if you'll buy adult glasses yourself, the test at your primary care facility is covered.

2. Prioritise the kids The KES 1,000 household limit goes furthest on children's glasses.

3. Plan surgeries across the household Two major procedures per household per year. If a parent needs cataract surgery and someone else needs a major operation, the limit is shared.

4. Check your employer cover Many employers add optical cover on top of SHA. Ask HR.

What If You Need Contact Lenses?

SHA's optical package covers glasses, not contact lenses. If you need contacts, you'll pay yourself or use private cover.

Private Insurance for Better Optical

If optical matters to you, a private plan with an optical benefit fills the gap SHA leaves: adult glasses, better frames, lenses.

Optical is usually an add-on to outpatient cover, and limits vary by insurer and plan. See how SHA and private cover fit together in best private insurance to top up SHA, or get a price on the health insurance calculator.

The Bottom Line

• Eye tests: covered for everyone
• Glasses: under-18s only, KES 950 a pair, KES 1,000 per household a year
• Cataract and glaucoma surgery: KES 33,600 each
• Adult glasses: on you, or on private cover

For the full picture of what SHA pays across every benefit, read SHA cover limits.

Next Steps

1. Get your eye test at your primary care facility
2. Check whether a facility is contracted before you go
3. Budget for adult glasses yourself
4. Consider private top-up if optical matters to you

Have more questions about SHA? Read my complete SHA guide.