Do we have rights to do so,let me check
NHIF
UAP leave them alone…
Woooooo total disappointment from them…
GA wako very OK.
then it must be an even bigger and dumber mutherfucker who did that!
thanks for the heads up!
never heard of them, lemmie do some research.
General Accident
Sorry I was kidogo busy but this is the continuation up:
UAP:
- You will copay
- Chronic conditions and HIV are not covered for the first one year.
- They have a list of county hospitals. You will not find the Aga Khans, Nairobi Hospitals, Mater etc. The hospitals you go to are akina Metropolitan, Nairobi womens, Coptic, Jamaa etc.
- You have to wait for 28 days before you can start using the cover for outpatient and 60 days for surgical
- Maximum age is 70 years
- No baby friendly vaccines
Madison:
- You will copay if you visit Aga Khan, Nairobi Hospital, Getrudes and Karen Hospital
- If you insure today, you wait for 21 days before you can use your card for outpatient, 45 days before you use it for in patient and 90 days for surgical cases.
- Outpatient cover excludes all dental treatment
- Maximum age is 60 years
- Overseas emergency treatment for the first 45 days
- No baby friendly vaccines
Resolution:
- You will co pay 1,000 when you visit big hospitals and 500 the rest
- Maximum age is 65 years
- If you insure today you wait for 21 days for outpatient, 30 days for inpatient and 10 months for surgeries
- Baby friendly vaccines up to 20k
- Annual well person check up for principal and spouse only. They test lipid profile, pap smear, prostate cancer, liver function, stool for occult, ECG, Nutritional consultation, blood sugar.
APA:
- Maximum age is 75 years
- Waiting period before using insurance is 30 days for outpatient and 90 days for surgery
All of them- pre existing conditions- first 12 months no cover.
Hio ku co pay ndio nini? 1000 tunagawanya nusu?
was about to ask the same thing
Yes. You pay 50% ya consultation fees.
BUPA is the best scheme available.
The question you should ask @The.Black.Templar is what horror stories & disappointment have talkers had from the medical insurance covers.
NHIF
Inpatient- 1M
Outpatient - 100000
Dental - 40000
Optical - 50000
Ksh 1300/month
NHIF iko sawa. The challenge is lack of drugs in most government hospitals.
This thread is the most resourceful so far in this year.
but they do not cater for so many things, if you get admitted, they just pay for the bed I think and you have to foot the rest of the bill yes, no?
I prefer pay and claim for minor medical attention.
Forget all the rest. Wait for the NHIF /Equity comprehensive scheme to come back on board and take it up. You will never need to worry ever again. Mambo ya pre existing conditions utakua onaona kwa view sasa. You will be guided by the budget and premiums you apply for. All insurance companies are fighting it as they will go under. Now most are chewing on providing only generic drugs to their policy holders
Thanks @Okiya.
Health insurance in Kenya is very expensive.
There are a couple of benefit items to each cover: inpatient, outpatient, dental, optical, maternity, last expense and personal accident. Companies will offer some or all of these. Most companies will offer the rest of the benefits after inpatient has been procured. A member can however pick the inpatient benefit only.
The big boys of the industry (by most premiums) are Jubilee, AAR, UAP, Resolution, Britam and CIC. Insure with only these.
There are so many exemptions and limits when it comes to medical insurance. Some are outright unfair e.g. pre-existing conditions, because the insurance company can twist the language to deny your claim. Your physician (and lawyer) are then needed to prove that the condition should be covered. Some limit the care that can provided under a benefit e.g. splitting a 4 million inpatient cover into 1m illness and 3m accident - if you have a stroke, you can only utilise 1m yet you have 3m remaining. Some lump optical and dental into your outpatient cover i.e. 100k outpatient but if you get prescription lenses, the amount is deducted from the 100k. If the spouse is pregnant in year 1 of cover she and the baby cannot be covered. You need pre-authorisation for pharmacy and lab that are more than 10k per visit. If they decline, you pay cash. Some restrict you to their clinics for the initial consult…AAR! Contraception is not covered yet 100% of ladies might need it - weird!
Basically, insurance business is nothing short of exploitation. If you can do without it (you have access to assets or liquid cash like 2m) don’t get it. Pay cash, you negotiate fees with your doctor, cheaper. Let NHIF settle some of the bills for you, pay the rest in cash.
The numbers: If you have a family of 4 (Member, Spouse, Child 1, Child 2) you will pay between 180k and 250k for 2M-3M inpatient, 100k-150k outpatient, 10k-20k dental, 10k-20k optical, 100k-150k maternity, 50k last expense, 500k personal accident.
A 1m inpatient-only cover for the member only will cost approx: 22100 (Jub), 31052 (UAP), 30924 (AAR), 20088 (Resolution). If you are admitted in HDU or ICU, 1m will not last 5 days. Treatment for severe pneumonia at MP Shah will cost 350k minimum. Road Traffic Accident with unilateral fracture mid-shaft femur with surgery cost 600k minimum. If you stay in hospital for more than 1 week, that 1m will be gone. These “basic” covers that are below 2M are treated with more scrutiny and higher chances of your claims being declined because this group of members consume their benefits the most (middle-class).
The older you are, the larger your family, the more fertile your spouse, the more visits you make to outpatient/inpatient, etc. the more you will pay in premiums.
Consider the hospital that you visit most, if it is one of the big ones, a co-payment of 500-1000 will be needed i.e. you pay 1000 before treatment even though you have insurance cover! They say that it is meant to reduce the number of visits Kenyans make to expensive hospitals.
Pick a company that you prefer, walk into their corporate offices (I don’t really trust agents), and get full information. Hop from one to the next until you are happy with their reception and the package. Pay the FULL premium (claims are denied if cover is not paid in full), get a receipt and wait 30 days for your cover and your smart card to be active.
Depends on how much you pay per month