What NHIMA is
The National Health Insurance Management Authority runs Zambia's national health insurance scheme. Contributions fund access to health services at accredited facilities for members and their registered dependants.
Membership is mandatory for employees in the formal sector, which is why the deduction appears on every compliant payslip.
The rate: 1% from you, 1% from your employer
You contribute 1% of your basic salary. Your employer contributes a matching 1% as an employer cost. That half is not deducted from your pay and will not appear on your payslip as a deduction.
Total funding per employee is therefore 2% of basic salary, but only half of that changes your take-home figure.
Basic salary, not gross, and why it matters
This is the detail that trips people up, and it is worth being precise about because payroll systems disagree. The base is set by the Third Schedule of the National Health Insurance (General) Regulations, SI No. 63 of 2019, which specifies 1% of basic salary. Some payroll software charges NHIMA on gross instead, which over-deducts from anyone with an allowance component.
Zambia's three payroll deductions each use a different base:
| Deduction | Charged on | Ceiling? |
|---|---|---|
| PAYE | Gross emoluments | No, banded rates |
| NAPSA | Gross earnings | Yes, capped monthly |
| NHIMA | Basic salary only | No ceiling |
Consider two employees each on a K15,000 package. One has K15,000 as basic salary; the other has K10,000 basic plus K5,000 in allowances. Their PAYE and NAPSA are identical, but their NHIMA is not:
- All-basic package: 1% of K15,000 = K150.00
- Split package: 1% of K10,000 = K100.00
The salary calculator handles this distinction automatically. Enter your basic salary and allowances separately and it applies each deduction to the correct base.
No ceiling
Unlike NAPSA, NHIMA has no cap. The 1% keeps applying however high the basic salary goes, so for senior earners NHIMA can eventually exceed the NAPSA deduction. NAPSA stops growing at its ceiling while NHIMA does not.
What the cover includes
Registered members and their declared dependants can access services at NHIMA-accredited public and private facilities. Cover typically spans outpatient consultations, prescribed medicines on the scheme's formulary, diagnostics, and inpatient care, subject to the benefit package in force.
Dependants must be registered to be covered. Contributing alone does not automatically extend cover to a spouse or children who have never been declared to NHIMA.
What employers must do
- Register the business and its employees with NHIMA.
- Deduct 1% of each employee's basic salary.
- Add the employer's matching 1%.
- Remit the total and file the monthly return on time.
If you would rather not run this alongside NAPSA, ZRA and WCFCB filings, we offer an agent service that handles the submissions for you.
Frequently asked questions
Is NHIMA deducted before PAYE?
No. PAYE is charged on your gross emoluments; NHIMA is calculated separately on basic salary. Neither reduces the base of the other.
Do I contribute if I am self-employed?
Yes. Self-employed and informal-sector members contribute directly to NHIMA rather than through an employer, on the terms NHIMA sets for voluntary and self-employed membership.
Can I opt out if I already have private medical cover?
No. NHIMA membership is a statutory obligation for employees, and private insurance does not exempt you. Many members hold both.
General information based on the NHIMA rate used by this site's calculator. Benefit details change from time to time, so confirm current cover and registration requirements with NHIMA directly.