Individual & Family Health Insurance
This way, it is a great tool for financial planning to handle any unexpected costs that may arise out of an illness or accident, these can otherwise wreck financial havoc and deplete any little savings and investments that one may have accumulated.
The majority of medical insurance companies in Kenya have opted to partner with hospitals, clinics and specialist providers outside the country for their clients, it is reliable and affordable compared to the local hospitals, clinics and providers. This has in away changed the dynamics in the industry with every company running to that direction to ensure they are better placed and keep their current clients.
What To Consider when looking for insurance.
You need a cover that meets most if not all of your basic needs when it comes to treatment for example if it will take care of day care treatment, Maternity, antenatal and post-natal care for young ladies who are looking forward to having a child, pre-existing and chronic conditions, dental and optical not forgetting laboratory test and prescribed drugs among others.
Types Of Insurance
Inpatient
Allows you to be admitted to a hospital for treatment that requires at least one overnight stay.
What’s Covered under inpatient
- Bed
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- Hospital accommodation charges are covered net of the NHIF rebate per day. This also depends on what your cover bed entitlement is i.e. Ensuite, standard private or general ward bed
- Congenital
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- Congenital is a state prevailing at or before birth regardless of cause. It is capped up to a particular limit depending on the inpatient limit you have taken. However it has a waiting period of one year or more depending on the Kenyan medical insurance company that offers your policy.
- Post Hospitalization
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- This is the period when one has been declared fit to go home but a he or she needs to undergo tests to monitor recuperation. Medical Insurance covers up to 60 days from discharge. Coverage limits depends on the package one has.
- Medical Tests
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- In medication process practitioners recommend various tests. Insurance cover extends coverage to these services but the laboratory must be in the approved panel of providers.
- Professional fees and specialists
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These are the various consultation fee paid to specialists e.g Neurologists and cardiologists, gynecologists. They are covered fully depending on the coverage limit.
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Outpatient
This allows you to attend a hospital or clinic for treatment without staying there overnight. Insured can also purchase additional cover specifically for optical and dental treatment.
What’s Covered under outpatient
- Outpatient consultations
- X-rays, laboratory, scans and MRI
- Laboratory
- Antenatal & Postnatal care
- Diagnostic examinations
- Well baby check-ups inclusive of KEPI Immunization Programme at our selected well baby clinics only.
- Injections and procedures performed at a primary care level in a doctor’s consultation room
- Prescribed medicines
- Minor trauma treatment
- HIV services
- Adherence and nutritional counselling
- Follow-up every 3months
- Prevention of mother to child Transmission (PMTCT)
- ARV’s and Monitoring
- Opportunistic infections
- Baby friendly vaccines as a benefit to the member child up to a sublimit of KSh 20,000.
Optical Insurance
The Optical Plan extend to covers the following services;
- Routine optical consultations
- Prescribed lenses and replacement of lenses
- Optical Prescriptions
- Prescription of frames
Dental Insurance
The Dental Plan extends to cover the following services;
- Consultation
- Crowning
- Bridging
- Braces
- Extractions
- Fillings (except precious metals)
- Scaling
- Dental X-Rays
- Dental Prescriptions
