The Classic plan Jubilee -Jcare

Medical Insurance

About this product

Inpatient benefits

 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
 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

Outpatient benefits (optional)

 Annual limits                                                 50,000
 Consultation fees (doctors on panel)  Paid in Full
 Pathology, Xrays, MRI, CT Scan and other necessary diagnostic tests *1  Paid in Full
 Prescription drugs and dressings upto a maximum of 30 days dosage  Paid in Full
 Gynacological illness and treatment*2  Paid in Full
 Pre-existing, chronic cover, Psychiatric, Congenital conditions and HIV/AIDS and related treatment ( 1 year waiting period)  Paid in Full
 Cancer treatment (2 year waiting period)  Paid in Full
 Physiotherapy (pre authorisation required)  Paid in Full

Maternity benefits (optional)

 Annual limit per member/spouse                                                 80,000
 KEPI Vaccinations (within maternity limit and subject to pre-authorisation)  up to 5,000
 Pre-natal & Ante-natal outpatient treatment ( 1 year waiting period)  Covered under maternity limit
 Benefits covered under maternity limit                            (1 year waiting period)  Normal and C-Section delivery.  Labour/recovery ward, professional fees, pregnancy/ maternity related hospitalisation, other related ailments & complications including etopic pregnancy and miscarriage

Dental benefits (optional)

 Annual Limit per person                                                   5,000
 Benefits covered (pre-authorisation required)  Dental Consultations, Extractions, Fillings, Dental Xrays and Prescriptions

Optical benefits (optional)

 Annual Limit per person                                                   5,000
 Benefits covered (pre-authorisation required)  1 eye test per person per annum.  Frames and prescription lenses every 2 years

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