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Health Insurance in Kenya – Medical Insurance in Kenya


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The Need For Health Insurance in Kenya

Anyone can get sick or be involved in an accident. Further more accidents and diseases come suddenly and when least expected. if this happens to you, or a member of your family, the cost of treatment could be high.

This is because it might involve you or your family member being hospitalized, paying doctors, buying medicine, and incurring many other charges.

Without medical insurance, people are expected to pay for health care costs out of their own pockets at the point of medical treatment. Buying a medical insurance policy ensures such medical charges are met by the insurance company.

How to Buy Medical Insurance in Kenya

Currently, there are many insurance companies in Kenya licensed to sell medical insurance. You can buy medical insurance directly from an insurance company or through an insurance broker or agent. These limits are put by insurance companies because one can only buy medical for their spouses, dependants, and themselves but not for their grown up children who are expected to be financially independent.

This way you do not need to have ready cash for a member of your family or yourself to be treated in a hospital as the insurance company will pay the bills on your behalf up to certain specified amounts which can vary depending on your ability to pay premiums.

A medical insurance gives you peace of mind so that you avoid harambees and need for a hospital deposit for admission to hospital as well as last expense component to avoid harambees for burials.

Tips on Buying Health Insurance in Kenya

When you are considering buying medical insurance in Kenya, bear in mind the following:

  1. There are policies which cover inpatient treatment only.
  2. Others cover both inpatient and outpatient medical treatment.
  3. It is up to you to decide whether to buy inpatient medical insurance only or both inpatient and outpatient medical insurance.
  4. A last expense cover can be added to take care of funeral expenses,
  5. Policies that cover both inpatient and outpatient are more expensive than those that cover inpatient treatment only,
  6. You should only buy medical insurance through licensed insurers, brokers, agents or organizations that you belong to.
  7. So.,go ahead and buy medical insurance,.. because your health and that of your family is too important to you!

3 Pro Secrets of Choosing Health Insurance in Kenya

We would like to make choosing a health insurance provider simple. In this post, we share with you the three secrets that all insurance pros use when making this important decision. These are actually the basic features every health insurance plan should offer you. Go ahead and use these tips as a guide to make your health insurance decisions. We know that getting a fitting cover for yourself and your loved ones can be daunting especially if you are doing it for the first time. We don’t think it needs not be so. Simply use these three keys to make life easy for yourself.

Health Insurance in Kenya – Find the Plan that has the Lowest Premiums

Cost should be a very important part of your decision to buy a health insurance plan. It is therefore important to determine the lowest cost possible that you should pay for a certain type of cover.

Health Insurance in Kenya – Find a Plan has the Best Coverage for your Needs

The purpose of buying health insurance is to meet certain insurance needs for yourself and your dependents. It is important to consider what your actual needs are before buying into a plan, even if it is an attractive and affordable plan. Ask yourself why you need medical insurance, and what type of specific needs you expect it to fulfil. If you dependents include small children, and if you are likely to need a maternity cover, find out whether the cover you are buying will meet these needs. It doesn’t make any sense to buy a cover that includes maternity cover if you are not expecting any more children. So ensure that the cover you buy covers you adequately, and does not have unnecessary expensive features.

Health Insurance in Kenya – Find an Insurer with the Best-fitting Panel of Hospitals for Your Needs

One of the cardinal elements of healthcare services is the quality of services you receive when you are sick. In this regard, it is crucial to make health insurance decisions with a full understanding of the panel of hospitals that you will have access to. If you frequently travel out of your primary residence, then a carrier with a national coverage will work best for you. On the other hand, if you want access to certain healthcare institutions, make sure the cover you buy gives you access to these institutions. Many insurance companies will have a copayment plan whenever you go to certain high-end hospitals for services. Get this information too, because it could inflate the cost of your medical expenses over time.

4 Reasons Why you Need Health Insurance in Kenya Now

For a long time, many people have brushed aside the need for health insurance and opted to “deal with things” as they come. The uptake of health insurance in Kenya remains low mainly because people who should have health covers are not keen on buying health insurance. Harambees to raise funds for medical emergency are still the norm. While giving is a good thing, we should leave it for real emergencies. Everyone gets sick at some point and so it is possible to plan for it. We can wipe out the medical emergencies culture if everyone has some type of medical insurance cover. Here are five reasons why you need to think about a medical insurance cover for yourself and your loved ones.

Medical Insurance in Kenya – Your health is Irreplaceable

If you lost your car, you can always buy another one, a newer one, a bigger one, or a better one. If you lost your job, same story, you can replace it. When it comes to your health, things are not that simple. You cannot just go somewhere and swap your health for a better one. You have only one health, and you must take good care of it if it is to serve you well during the long life that we wish you.

Medical Insurance in Kenya – It is better to have a cover and not need it

Some people argue that health insurance is an unnecessary and expensive expense. Well, it is possible that you will not need to see doctor for the entire period of your cover. The health insurance companies actually bank on the fact that only some of the people it has insured will actually need their services. However, you cannot tell with certainty that you will not fall sick in the next one year. To this extent, you would rather have health insurance and not use it rather than not have it and need it.

Medical Insurance in Kenya – Health Insurance is Affordable

If you have had an ear out on matters of health insurance, you may have come across the affordable insurance product from Britam dubbed “Linda Jamii”. As of early 2015, Linda Jamii was one of the most cost effective insurance products in the Kenyan market, and remains within reach of a large portion of Kenyans. The service only costs the equivalent of one thousand shillings per month (Payable annually). This is a signal that the medical insurance companies are looking for ways to make health insurance affordable. Our point here is that it is possible to get a wide range of policies that can meet your needs, and fit within your budget.

Important Issues When Choosing a Medical Insurance Provider in Kenya

We get it; when you are sick, you want treatment, not drama. This makes the choice of a health insurance carrier an important decision because it may have a significant influence on the quality of care you receive. If you are currently shopping for a medical cover, or you just want a feel of what is out there, then here are some things that you will do well to bear in mind.

Health Insurance in Kenya – A medical insurer is not a medical services provider

With the exception of companies like AAR that provide medical insurance and also run health centers, a vast majority of medical insurers do not offer any direct health services. They only finance healthcare for their members. This distinction is important to bear in mind for two reasons. First, it may mean the difference between having access to services from a large number of healthcare facilities that have a relationship with your insurer or being restricted to health centers run by your medical insurance provider. Secondly, it may mean that you are tied within an insurer’s network, and you may not be able to access services from certain hospitals. Always take time to ensure that the company you go with actually addresses your needs.

Health Insurance in Kenya – Reputation does Matter

It is critical to determine the reputation of your preferred health services provider before making commitments. If you can, ask hospitals and clinics what sort of relationship they have with the medical insurer, and find out whether the relations are smooth. Talk to your friends too, and other referrals to get their views on the services provided by that medical services provider. The market reputation of a provider is an indication of how well the company provides services to its members, and is usually a good point of reference when making decisions regarding healthcare insurance.

Health Insurance in Kenya – Consider the Reach of the Health Insurance Carrier

Depending on your lifestyle, it may be important to consider the geographical reach of your carrier. The main points to consider include the following. First, does the health insurance provider have a network of partner hospitals that cover all your main areas of operation? The point here is to ensure that you will have access to a hospital from any of your areas of operation. The second point to consider is whether the health insurance carrier allows you to use the hospitals of your choice. For instance, if you look at the Linda Jamii product from Britam, you will discover that the list of hospitals that participate in it do not include the major private hospitals in Nairobi, ostensibly to keep the costs of healthcare affordable both for the insurer and the insured. Other health insurance companies may insist on copayment plans if you visit the major private hospitals, or if you want to see a doctor outside of their primary network. Consider all these factors as you buy your medical insurance.

Health Insurance in Kenya – ALWAYS compare Costs and Services

Consider the costs of premiums, in the context of the size of cover available for your use. A cheap medical insurance cover does not always mean that it is a better deal. A company may give you an inferior cover at a low cost, which fails to meet your needs. On the other hand, a high cost cover is also not the same as a high quality cover. Examine the cover to ensure that you are getting the most value for your money. One of the best ways of doing this is to fill in our online medical insurance quote form to compare medical insurance quotes from different providers.

Health Insurance in Kenya – Make sure the provider is accessible especially on short notice

One of the most frustrating situations you can find yourself in is not being able to access your medical insurance provider when you need advice, or have an inquiry, especially during emergencies. Before you get into a scheme, call the company to find out how helpful they are when you have an inquiry. You can also experiment with sending an email or an sms to see which medium attracts the quickest and the most comprehensive response. Check out their website to see whether you can find the list of hospitals in their network, then call some of those hospitals to confirm that they actually have a relationship with this potential insurer. This is especially important if you would like to access services from specific hospitals listed in the company’s roll. Some company’s may not update the publicly available information when their relationships change, and you can buy into a cover thinking your preferred hospitals are in the network, only to discover that they are not represented. Do your research well to ensure that you get the best medical insurance cover possible on your current budget.

Factors to Consider when Setting up Corporate Medical Insurance in Kenya

Are you currently thinking of starting a health insurance scheme for your employees? Many employers spend hours agonizing over what they need to consider when evaluating health insurance companies to provide a medical benefits for their employees. If you think about it, this decision usually boils down to four main issues.

Medical Insurance in Kenya – What standard of care do you want to provide your employees?

Health Insurance in Kenya - Medical Insurance in Kenya

Health Insurance in Kenya – Medical Insurance in Kenya

In the Kenyan healthcare sector, one of the main differentiators among providers is standard of care they offer. The market, while mostly open to high-end clients, has various categories. Most health insurance companies have different products to cater for different market segments. What you need to make up your mind about is the level of care you want to provide for your employees. Many companies use a tiered system, which gives different benefits with different cover limits to different cadres of employees. The level of care you choose will have an impact on the type of hospitals that your employees can visit for treatment, which will in turn determine whether they will consider you a caring employer.

Medical Insurance in Kenya – Do you want to cover the dependents of your employees?

The second important question you need to address is whether you want to cover the dependents of your employees. First-rate companies usually offer a cover for the dependents of their employees in an effort to keep the employees motivated and as an employee retention strategy. In this regard, you need to consider what this means for your company, and whether your organization can afford it. It is possible to get great rates, usually on a cascading scale for every additional dependent your employees have. In effect, the total cost of providing health benefits for dependents under your corporate scheme will be lower than the cost of providing this service for individuals.

Medical Insurance in Kenya – What is your Budget?

Your budget is one of the key factors that should guide your decision to buy insurance for your employees. Private health insurance is usually provided as an employment benefit and it is not a legal requirement (NHIF is a legal requirement). However, serious employers demonstrate their commitment to their employees by providing them with health insurance. In this sense, health insurance schemes have become a need-to-have benefit that demonstrates your seriousness as an employer. Make sure that you have set aside and can sustain the level of care you want to provide for your employees. If need be, use a co-payment plan to help set up the scheme and then gradually take up the tab as your budget for this item increases.

Medical Insurance in Kenya – Which scheme will give your employees the best cover for your budgets?

The final bit in this process is collating the information you have gathered. One crucial piece of information you need is the actual cost of offering the service. It can be time consuming to get credible figures from all the health insurance firms in Kenya. This process need not be difficult any more. Get these rates by filling our free quote form, and then submit the form to an insurance company of your choice.

Health Insurance Guide for Expectant Moms and Dads

One of our goals at insureafrika is to provide you with as much information as you need to help you make insurance decisions. One area in insurance that attracts many questions is maternal health. You see, once you are married, getting a baby cannot be considered an insurable risk because it is highly likely that you will get a baby. Compare this to car insurance where insurance companies actually provide services based on how low the chances are that you will actually need insurance. We have picked out eight of the most critical insurance questions every mom (and dad-especially dads), need to be aware of during maternity.

Health Insurance in Kenya – Do insurance companies cover maternity costs?

Yes they do. Many insurance companies today offer maternity cover as an annex of the primary health cover. While this goes against the intuitive nature of insurance, companies have found a way to offer maternal health covers which pays your hospitalization bills before, during, and after childbirth.

Health Insurance in Kenya – Is the cover ceiling for natural birth the same as the cover for Caesarean section?

No. insurance companies have difference ceilings for natural birth and CS. The cost of CS in any hospital can be between three to five times the costs of natural birth. This is because CS involves the use of a theatre, and the mother also require post operative care. The number of days a new mom stays in hospital are usually more after CS than after natural childbirth. Health insurance companies therefore have different ceilings because they treat them as different procedures.

Health Insurance in Kenya – I am already pregnant. Can I rush to buy health insurance?

Unfortunately, if you are already pregnant and you have not bought a cover that includes maternal care, then you are late. It is still advisable to buy some type of health cover because pregnancy can be very unpredictable. In case of any complications, you may be able to claim some money from your insurer, without the costs of actual delivery.

Health Insurance in Kenya – What if my baby is born with a disease or a birth defect?

Many times, a maternal health cover will also include a clause on congenital illnesses. This means that if your baby is born with a birth defect, or requires emergency care immediately after birth, you insurance company will step in and cover these costs of care. It is advisable to discuss with your insurer whether they have any exclusion in regards to the cover extended to your newborn. It is also important to know what the limit of that cover is.

Health Insurance in Kenya – How do I get the best rates for maternal care?

The quickest and most effective way of getting good quotes for maternal cover is by filling in the insureafrika health insurance quote form. This is a free service from insureafrika designed to give you all the information you need to make critical decisions regarding your cover. Please remember that maternal cover is usually bundled as part of your health insurance cover, and may not exist on its own. Fill our form to see which companies have the best rates.

Health Insurance in Kenya – Will my insurer pay for prenatal and post-natal care?

Yes, prenatal and postnatal care usually falls under the purview of your health cover. It helps to know whether your insurer has any exclusions and limits when it comes to maternal covers. For instance, you insurer may have a limit on the number of scans that they pay for during prenatal care, and may also have exclusions on which medicines they pay for. Many insurance companies do not pay for supplements or may insist on case-by-case approval for supplements when prescribed.

Health Insurance in Kenya – How soon can I buy insurance for my newborn child?

As soon as your child is born, it is important to get a health cover. The baby is a separate person, and is not covered except under the congenital illness clause. Therefore, do your best to get a cover for your baby as soon as reasonably possible to ensure that your baby is covered.

Health Insurance in Kenya – Is it possible to spend nothing during the entire delivery process?

Yes and no. Yes, the maternal cover can finance your entire stay in hospital and you will not need to pay any fees for healthcare in the hospital. This is especially possible if there are no complications during childbirth. No, because there are items that health insurance companies will not pay for. This include diapers, baby formula (if used), and personal care products for you and your baby. It is highly advisable to have some cash at hand to take care of any incidental costs and the cost of buying personal care products.

NHIF Cover: Insufficient, but Absolutely Necessary

Insufficient but necessary- let’s get that straight from the onset. NHIF exists to make healthcare in Kenya affordable for as many Kenyans as care to be members. The fund is an attempt by the Kenyan government to ensure that all Kenyans can afford the cost of healthcare through universal Health insurance. The way NHIF works is that it collects money from all employed persons (also open to self-employed persons) based on their salaries and uses this pool of funds to pay for healthcare whenever any member is hospitalized. Beginning 2015, NHIF will pay for the cost of outpatient services for all its members.

The fund works on a co-payment basis, and usually caters for the basic costs of hospitalization. Just like many health insurance companies in Kenya, NHIF does not pay for elective and cosmetic procedures. This means that if you want a fancy medical procedure, you will bear the cost. In addition, NHIF only covers the basic costs. If you choose to go to a high-end hospital for your treatment, you will need to foot any bill in excess of the amount that NHIF covers.

Many insurance companies calculate the money they owe to hospitals after subtracting deductions form NHIF. This means that the private medical insurance cover kicks in only after you exhaust your NHIF cover. If you are not an active member of NHIF Kenya, you will bear an equivalent cost on your own.

An NHIF cover is very important, and in some cases, it may cover the full cost of treatment in a medical facility. However, the cost of adequate healthcare is usually higher that what NHIF covers. In addition, when you factor in the exclusions in the NHIF cover, you will soon see that having the cover is important, and even advisable, but you cannot entirely rely on it to assure yourself of a good cover for you and your loved ones.
Whatever you do, make sure you have the NHIF cover, but don’t rest on your laurels, get another fitting cover to sufficiently protect you and your family from medical eventualities.

Health Insurance in Kenya – Limits, Exclusions, Copayment and Waiting Period

Whenever you are evaluating any health insurance product, you must keep an eye for four key aspect of the insurance cover that play a very critical part in the overall quality of the cover. Not all covers are the same, and you should be aware that different companies use different approaches to optimize their products.

Health Insurance in Kenya – The Cover Limit

Every cover will have limits. A limit is the maximum amount of money you can spend based on your current policy. The main limits you need to keep an eye on are the inpatient and the outpatient limits. The inpatient limit is the total amount of money available for use when you are hospitalized. The outpatient limit on the other hand refers to the amount of money you can spend on clinics and other non-residential care centers approved by your insurer. Other critical limits that you need to know include the dental cover limit, the optical cover limit, and congenital cover limit, among others.

Health Insurance in Kenya – Exclusions

It is very important to understand the exclusions associated with any insurance policy before buying it. Insurance companies use limits to protect themselves against financial ruin in the unlikely situation that many policyholders make claims within a certain period. Some of the exclusions are based on the non-medical services one may intend to access using their medical cover. These services include elective cosmetic surgery, alternative -medicine services such as acupuncture, and non-clinical health interventions. In addition to these, medical insurance companies also exclude medicines, even if prescribed, that are classified as supplements. Cosmetics also are not included in a medical cover, unless needed for medical purposes.

Health Insurance in Kenya – Co Payment

One other strategy that insurance companies use to control their costs includes the concept of copayment. Copayment works for clients who want to access services from specialists or from certain high-end medical facilities that have higher costs of care. The use of this system enables health insurance companies to include high-end medical facilities in their panel of hospitals. It enables Insurance companies to transfer some of their liability to policyholders who want to access these high-end institutions. When you take out a medical cover, be keen to study the copayment policy of the health insurance company to understand what it will cost you to access high-end hospitals, over and above the costs covered by your policy.

Health Insurance in Kenya – Waiting Period

The concept of a waiting period arises from the need to mitigate the risk of someone seeking insurance after falling ill. One of the cardinal principles of insurance is risk. Something certain ceases to be a risk, and as such it is not insurable. In this regard, insurance companies have different policies relating to the waiting period for core services and chronic illnesses.

Health Insurance Companies in Kenya

It pays to shop around for insurance because you really can save money by researching rates from different medical insurance companies in Kenya. When you compare insurance rates. you receive a range of price lavels for identical coverage.

List of Medical Insurance Companies in Kenya.

  1. AAR Insurance Kenya Limited
  2. Africa Merchant Assurance Company Limited
  3. AIG Kenya Insurance Company Limited
  4. APA Insurance Limited
  5. Apollo Life Assurance Limited
  6. Britam Insurance Company
  7. Cannon Assurance Limited
  8. Capex Life Assurance Company Limited
  9. CFC Life Assurance Company Limited
  10. CIC General Insurance Limited

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