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Optical and Dental Medical Insurance in Kenya

Posted on 2018-07-18
Optical and Dental Medical Insurance in Kenya

Medical insurance plans in Kenya are the most popularly searched for type of insurance covers for the general public. Individuals and families are in need of a comprehensive health insurance plan that can offer convenience and cost savings especially when in need of medical attention. Commonly many Kenyans are reduced to fundraising when faced with an unfortunate and critical medical condition. One question that comes up time and again is the benefits and price of the optical and dental insurance covers. For those with eye and teeth conditions requiring the services of opticians and dentists, these can become an unexpected cost, draining one's savings.

Going by the prices of dentist and optician services in Kenya, a basic 30 minutes consultation goes for as much as KSh 5,000 while eye tests and a pair of spectacles can cost well over KSh 10,000 per visit. It is no wonder that many Kenyans want to invest in a comprehensive private medical insurance plan.

Corporate medical insurance covers

A large number of Kenyans are covered on corporate and SME medical insurances provided by their employers. On these schemes, most of the health insurance benefits are customised and tailored per scheme. As such, some corporate medical insurance schemes may have no provision for optical and dental medical insurances while others may provide generous limits for individuals or as shared benefit for the employee’s family.

Optical Health insurance

Optical and Dental Health insurance on NHIF Kenya

The National Health Insurance Fund (NHIF) has given millions of Kenyans a chance to get universal health insurance cover. One can access this cover by paying as low as KSh 500 per month. One can enjoy a variety of dental services countrywide including tooth extraction and filling among others. Similarly the universal health cover also caters for optical medical services at selected providers countrywide.

Kenyan Private medical insurances

Most of the leading private medical insurance companies in Kenya offer dental and optical as part of the health insurance packages. There are two important distinctions to note.

Firstly, these benefits are to be enjoyed as part of out patient procedures meaning they can not be enjoyed when one is admitted in the hospital overnight.
Not to worry as the insurance companies provide generous sub-limits under the inpatient medical insurance plans. These limits are under the dental illness and ophthalmology limits. An ophthalmologist is a specialist in medical and surgical eye diseases

Second is that some providers like AAR insurance Kenya provide these optical and dental benefits as a sublimit under the outpatient plan. That means that clients who purchase any outpatient plan automatically have coverage for optical and dental costs.

The majority of the other health insurance companies in Kenya offer the dental and optical benefits as standalone add-ons which have to be included on the outpatient plan. So, a customer has to purchase an inpatient plan, include an outpatient plan and then bolt on the optical and dental add-ons. Also worth noting that these two add-ons must be taken together when one decides to take any one. That is, it’s not possible to only take a dental add-ons without taking the optical add-ons. Health insurance companies in Kenya like Jubilee Insurance, UAP Medical insurance, Resolution Health insurance company and more all offer these optical and dental benefits. Moreover, for families it is not possible to take these add-ons for just one family member and not the others. Once the benefits are purchased, one has to purchase them for all the members insured.

An additional point worth noting is to take care to choose a medical insurance company that has a wider network of hospitals and clinics. Most health insurance companies in Kenya have a special panel for dentists and opticians countrywide, so it is important to pick one that has sufficient providers on it.

The following are some of the benefits covered in a typical optical insurance plan in Kenya

  1. Routine optical consultations
  2. Prescription of frames
  3. Prescribed lenses and replacement of lenses
  4. Optical Prescriptions

Most health insurance companies will limit how much one can claim on some benefits under the optical insurance such as eye glasses and spectacles so that it is not misused.

The below benefits are typically offered on a dental insurance plan in Kenya subject to the overall limit of cover

  • Consultation
  • Extractions
  • Fillings (except precious metals)
  • Scaling
  • Dental X-Rays
  • Dental Prescriptions
  • Crowning
  • Bridging
  • Braces

Dental and Optical Medical insurance Rates

Most of the packages offered by medical insurance companies have limits from as low as KSh 5,000 going up 50,000 of cover depending on the provider. The rates for the optical and dental are charged per individual on cover. Insurance rates as low as KSh 2,100 for each add-on (optical or dental) and the rates do not change with the age of the insured.


If you are looking for quotes for optical and dental 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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