In-patient medical or private health insurance in Kenya refers to treatment received in a hospital where an overnight stay is medically necessary. In-patient benefits include things like hospital accommodation, anaesthesia and theatre charges, surgical fees, surgical appliances, prostheses and diagnostic tests.
To talk to a specialist on medical insurance contact +254752055688.
For all in-patient and day-case treatment costs:
- it must be medically essential for you to occupy a hospital bed to receive the treatment
- your treatment must be provided, or overseen, by a consultant
- we pay for accommodation in a room that is no more expensive than the hospital’s standard single room with a private bathroom. This means that we will not pay the extra costs of a deluxe, executive or VIP suite etc.
- if the cost of treatment is linked to the type of room, we pay the cost of treatment at the rate which would be charged if you occupied a standard single room with a private bathroom in the hospital where you have your treatment must be recognised
Our Medical Provider directory is available on the website.
This online directory allows you to search for hospitals, clinics, doctors and specialists on a county to county basis, with the ability to narrow down the search to specific regions.
| INPATIENT LIMIT | KES10,000,000.00 | KES5,000,000.00 | KES2,500,000.00 | KES1,000,000.00 | KES500,000.00 | KES300,000.00 | KES200,000.00 |
 |
|
|
|
|
|
|
|
| Bed limits | Private room | Private room | Private room | Private room | Standard Ward | Standard Ward | Standard Ward |
| Prescription drugs and dressings | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Physicians fees | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Specialist fees | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Surgical fees including anaesthetist | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Diagnostic Tests: Pathology | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Diagnostic Tests: Radiology | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Any other diagnostic tests | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Theatre charges | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| High Dependency Unit | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Intensive Care Unit | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Diagnostic tests | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Pre-existing conditions On full disclosure at the time of joining |
KES 1,000,000.00 | KES 500,000.00 | KES 250,000.00 | KES 100,000.00 | KES 75,000.00 | KES 65,000.00 | KES 50,000.00 |
|
Chronic conditions |
KES 1,000,000.00 | KES 500,000.00 | KES 250,000.00 | KES 100,000.00 | KES 75,000.00 | KES 65,000.00 | KES 50,000.00 |
| HIV/AIDS On full disclosure at the time of joining |
KES 1,000,000.00 | KES 500,000.00 | KES 250,000.00 | KES 100,000.00 | KES 75,000.00 | KES 65,000.00 | KES 50,000.00 |
| Cancer treatment | Covered | Covered | Covered | Covered | After 3rd year | After 3rd year | After 3rd year |
|
Organ transplantation |
Covered | Covered | Covered | Covered | Covered | Covered | Covered |
| Organ transplantation covers operation costs for Kidney transplants ,Heart transplants , Liver transplants , Lung transplants and Bone Marrow transplants excluding cost of obtaining the donor organ | |||||||
| Surgical appliances and internal prostheses | KES 500,000.00 | KES 300,000.00 | KES 200,000.00 | KES 200,000.00 | KES 100,000.00 | KES 65,000.00 | KES 50,000.00 |
| Accommodation costs for 1 parent staying in hospital with insured child | Paid In Full | Child under 6 years paid In Full | Child under 6 years paid In Full | Child under 6 years paid In Full | Child under 6 years paid In Full | Child under 6 years paid In Full | Child under 6 years paid In Full |
| Day Care Surgery under General anaesthesia | 30 Days | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Local ambulance to hospital for emergency cases | Paid In Full | Covered | Covered | Covered | Covered | Covered | Covered |
| Local ambulance offered by the following professional emergency medical assistance providers: Red Cross Ambulance (E Plus), St. Johns Ambulance | |||||||
| Air evacuation through AMREF per event | KES 300,000.00 | KES 300,000.00 | KES 180,000.00 | KES 180,000.00 | KES 180,000.00 | KES 180,000.00 | KES 180,000.00 |
| Treatment outside Kenya where treatment is not locally available (Preauthorisation required) | Allowed on reimbursement | Allowed on reimbursement | Allowed on reimbursement | Allowed on reimbursement | Allowed on reimbursement | Allowed on reimbursement | Allowed on reimbursement |
| CT, MRI and PET scans subject to pre authorisation | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Maternity expenses (normal & caesarean) related complications | KES 100,000.00 | KES 100,000.00 | KES 100,000.00 | KES 75,000.00 | KES 50,000.00 | KES 50,000.00 | KES 50,000.00 |
| InPatient Ophthalmology: includes cost of cataract removal | KES 100,000.00 | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| In Patient Dental | KES 100,000.00 | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Emergency dental or Optical treatment following accident | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full | Paid In Full |
| Funeral expenses – No Exclusions | KES 100,000.00 | KES 50,000.00 | KES 50,000.00 | KES 50,000.00 | KES 50,000.00 | KES 50,000.00 | KES 50,000.00 |
Chat now via WhatsApp 
