| Overall benefit limits in KShs. per insured family per annum |
500,000 |
| Pre -existing, Chronic, Congenital Conditions, HIV/ AIDS and related conditions existing/not existing and/ or not diagnosed at the time of joining. Subject to full disclosure at the time of joining (1 year waiting period) |
250,000 |
| Cancer treatment |
2 years waiting period |
| Organ Transplant |
1 year waiting period |
| Psychiatric conditions (1 year waiting period) |
100,000 |
| Bed limits per day net of NHIF |
General Ward Bed |
| Lodger Fees for parent accompanying sick child member |
Covered for Child under 8 |
| Physicians, specialists, surgical fees including anaesthetist fees, theatre charges, HDU, CCU & ICU, Diagnostic Tests, physiotherapy as part of inpatient treatment |
Paid in Full |
| Inpatient MRI/CT Scans and PET Scans (authorisation required) |
Paid in Full |
| Surgical appliances/internal prosthesis |
Paid in Full |
| Reconstructive surgery following an accident |
Paid in Full |
| Inpatient non accident related dental surgery/treatment (1 year waiting period) |
100,000 |
| Inpatient dental surgery from an accident |
Paid in Full |
| Inpatient opthalmology surgery as a result of an accident |
Paid in Full |
| Inpatient non accident related eye treatment (excluding correction of refractive errors and laser treatment) (1 year waiting period) |
100,000 |
| Day case surgery under general anaesthesia |
Paid in Full |
| Medically necessary home nursing on doctor’s recommendation after discharge from hospital |
90 days |
| Post hospitalisation treatment |
up to 3 weeks after discharge. Max 10,000 |
| Discharge take home medication |
up to 30 days after discharge |
| OTHER BENEFITS INCLUDED WITHIN INPATIENT COVER |
LIMIT |
| Local road ambulance to hospital for emergency cases |
Covered |
| Commercial Air Evacuation out of Kenya (must be pre authorised) for treatment not available or not safe to undertake locally |
Not applicable |
| Funeral expenses - (free for principal member. Optional for dependant over 18 yrs.) |
50,000 |
| Personal Accident (Free for Principal Member. Optional for dependents over 18 yrs.) |
500,000 |
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