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Affordable Medical Insurance Covers in Kenya

Posted on 2018-08-22
Affordable Medical Insurance Covers in Kenya

Our health is perhaps our most treasured asset. It is no wonder that health insurance in Kenya is perhaps the most searched for and purchased in the insurance industry. While many corporate employees are under company medical insurance schemes, many members of the public are under retail medical insurance plans and also the government medical insurance scheme, the NHIF. In addition, many high-income earners take out international medical insurance plans, which offer coverage in Kenya and other selected regions worldwide.

To get an affordable health insurance in cover, it is important to go shopping around for your exact needs and budget.
The below are some of the most affordable medical insurances in Kenya

NHIF Medical Insurance Cover

The NHIF medical insurance scheme is the largest scheme in Kenya mandated and operated by the government. It is open to the members of the public individually, families, SMEs and corporates. It covers medical costs for inpatient, outpatient, and maternity, dental and optical benefits. The scheme has improved benefits from 2017, allowing for dialysis treatments, chemotherapy, C- Section deliveries, overseas treatments and many more. Moreover, the NHIF medical insurance also allows members to visit any hospital in the network of providers. Most of the high end facilities like Aga Khan, Nairobi Hospital, Kenyatta and others are included in the panel. In total, the NHIF has contracted hospitals and medical facilities under Category A, B and C and members can visit any one such.

One of the major advantages of the NHIF scheme is that it has no limitations for pre-existing medical conditions and has no cut off age for new members joining or renewing. This is one of the biggest downsides of private medical insurance covers in Kenya. In addition, there is no waiting periods for most NHIF benefits, while for things like maternity most members have to wait at least 12 months on a private medical insurance. In fact, this article explains the benefits of the NHIF maternity cover in Kenya

NHIF Medical Insurance Rates

The medical insurance premiums for the NHIF vary quite significantly. For the self-employed, a monthly contribution of KSh 500 is all it takes to cover a principle and his/her entire first family. For the salaried individuals, the insurance premium rates go from as low as KSh 150 monthly to KSh 1700 per month.

NHIF Medical Benefits

Below is the list of benefits for the NHIF Inpatient, Outpatient, Renal and Maternity benefits:

  • Consultation
  • Hospital daily charges
  • Nursing care
  • Prescribed diagnostic laboratory or other medically necessary services
  • Physician's, surgeon's, anaesthetics' or physiotherapist's fees
  • Operating theatre charges
  • Specialist consultations or visits
  • Prescribed drugs/medications and dressings
  • General Consultation
  • Diagnostics and treatment of common ailments
  • Laboratory and investigation
  • Prescribed Drugs administration and dispensing
  • Management of chronic ailments (HIV/AIDS, Diabetes, Asthma, Hypertension, cancer)
  • Health and wellness education/healthcare counselling such as Screening for conditions e.g. cervical and prostate cancer.
  • Treatment of sexually transmitted diseases
  • Radiology Services
  • Family planning/midwifery/ante/post-natal services
  • Physiotherapy Services
  • Referral for specialized services
  • Renal dialysis package
  • Consultation and treatment for both mother and child
  • Child birth including caesarean section deliveries
  • Family planning services

APA Jamii Medical Insurance

APA Afya Nafuu Medical Insurance Cover

This is the other medical insurance plan from APA Insurance Kenya. The higher market APA Jamii Plus medical insurance offers the very best in local and international medical treatment. The APA Afya Nafuu is an affordable medical plan, which excludes the high end hospitals and providers but still maintains a versatile panel of hospitals, clinics, pharmacists and specialists. Among the panel are the avenue hospitals, Coptic and Meridian hospitals. It covers inpatient and outpatient medical costs, HDU, ICU, ward charges among others. It covers the largest age group from birth all the way to 75 years of age. For this reason it can also double as a seniors medical insurance plan in Kenya.

Afya Nafuu medical insurances

Medical insurance rates: For an adult of 35 years taking an inpatient limit of 1 Million and outpatient of 50,000, this costs KSh 29,200 per annum

UAP Afya County Medical Insurance

The UAP Afya County medical insurance product is perhaps the most affordable health insurance plan for retail customers in the Kenyan market. It admits all members from age of birth to 65 years old and existing members can renew till the age of 70 years. It was initially targeted at customers in the counties but has proved to be equally popular with Nairobi residents too.

It covers both in-patient and out patient medical costs, clients can also purchase an optional rider for maternity insurance.
The insurance covers pre-existing conditions, chronic conditions including HIV/AIDS and cancer after waiting period of 1 year. Of the other lower end covers, this also offers air evacuation by AMREF to persons with a cover of KSh 1 million limit and above.

UAP Medical insurance rates: For an adult of 35 years taking an inpatient limit of KSh 1 million and an outpatient of KSh 50,000 the cost comes to KSh 20,504 per annum.

Avenue Health Medical Insurance *

The Avenue Health medical centres have a wide network of hospitals across the country and have built a strong brand among low to middle income earners. They provide a health insurance package where members can seek treatment in Avenue facilities countrywide. Avenue has over 20 locations in Kisumu, Nairobi, Kajiado, Mombasa, Thika, Eldoret,and Nakuru.

The Avenue medical insurance provides different options for inpatient covers from limits of as low as KSh 100,000 up to KSh 1,000,000.
Unfortunately, this cover can only be taken as a group, it is not available to individuals and families.

Health cover rates: For a typical plan of a 35 years old adult covering Unlimited Outpatient visits and 1 Million inpatient, each member would have to KSh 27,000 per annum.

CIC Insurance

CIC Afya Bora Health Insurance Plans *

This is one of the cheapest plans on the market today offering affordable medical insurance at pocket friendly prices for the lower income segment of the market. The policy provides both In-patient and Outpatient benefits for a family of M+6 (i.e. principle and 6 additional members) for a premium of KSh. 35,000 per family regardless of the family size up to a maximum of 7 family members and KSh 4,500 any additional child. The details of the medical cover include an inpatient limit of KSh 250,000 and outpatient of KSh 50,000 shared by the entire family. IN addition, the CIC medical insurance cover also provides for the last expense benefit of KSh 50,000 in case of death of the principle. It also covers maternity subject to a waiting period of 1 year up to a limit of KSh 30,000 for both normal and CS deliveries.

Unfortunately, this health insurance plan is also only available to organised and registered groups e.g. MFIs, SACCOs, SMEs and corporates.

Outpatient CIC Afya Bora Medical insurance benefits:

  • Outpatient Consultation as per negotiated rates
  • Prescription drugs (Prescriptions above 5,000 require pre-authorisation)
  • Prescribed routine laboratory tests
  • Radiology (X-ray and Ultrasound) - (CT Scan and MRI NOT covered)
  • Pre-existing and chronic conditions up to KSh 20,000 - (Subject to 6 months waiting period)
  • Maternity – ANC (Max 1 U/S Scan) & PNC only (up to 6 weeks post partum)
  • Psychiatry and psychotherapy
  • Immunizations (KEPI)
  • Dental cover up to KSh 7,500
  • Optical cover up to KSh 7,500

Health insurance cover prices: KSh 35,000 per annum per family of up to 7 members.

BRITAM Afya Tele Medical Insurance Cover*

BRITAM is one of the most famous insurance companies in the East and Central African region. It offers general, life and medical insurance and also investment solutions. It rose to great prominence for the Linda Jamii medical insurance partnership it run together with SAFARICOM which was also a low cost medical insurance cover that ultimately got discontinued. The BRITAM Afya Tele is a low cost medical insurance for low-income earners in organised groups like SACCOs. It covers for inpatient, outpatient and last expense benefits including the maternity cover. It has limits of 200,000 and 300,000 for the inpatient limits and covers the maternity up to KSh 20,000 and 30,000 respectively. Members up to 65 years of age are welcome to join the scheme, It has standard waiting periods and exclusions similar to most retail private health insurance covers in Kenya.

Health insurance premium rates: For a single adult with a limit of KSh 300,000 inpatient and 50,000 outpatient, the medical insurance premiums cost KSh 16,000 per annum.

Medical insurance plan Premium rates (KSh) Description
NHIF 6,000 Government scheme
APA Afya Nafuu 29,200 Private for individuals and families – large hospital
UAP Afya County 20,504 Private for individuals and families – large hospital panel
Avenue Health* 27,000 Private for SMEs, SACCOs and groups – limited to Avenue clinics
CIC Afya Bora* 35,000 Private for SMEs, SACCOs and groups – per family of 7 members
BRITAM Afya Tele* 16,000 Private for SMEs, SACCOs and groups – for one adult

Table: Comparison of affordable medical insurance plans in Kenya


If you are looking for quotes for for individual, family or seniors medical covers or just want to compare the different offerings in the market, get in touch with us on our contact details below or simply start an online chat with one of insurance experts. Check out the benefits, prices and providers by viewing an online quote here , do you want to see what other customers are saying about the insurance covers they have taken? See customer reviews here

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