This study examines the effects of disability and serious illness on the likelihood of health insurance subscription among urban refugees in Kenya during the COVID-19 pandemic. Using data from the United Nations High Commission on Refugees (UNHCR) and the Treatment Effects Probit regression model, the study found that households with disabled members or those experiencing serious illnesses had higher probabilities of subscribing to the National Hospital Insurance Fund (NHIF). The results emphasize the role of socioeconomic factors such as community-based organizations (CBOs), household assets, and financial savings in determining insurance uptake. Policy recommendations include targeted interventions to improve insurance accessibility among vulnerable groups.