Medical Insurance
A Medical Insurance cover in Kenya is the coverage plan that protects you against risks due to a number of medical conditions. This may include serious illness, chronic diseases, physical injuries, disablement or even death. It covers all expenses before and after hospitalization period.
At Edenbridge capital, we have partnered with major insurance providers to offer you affordable health insurance quotes for individuals, couples and families. We help our clients minimize their risk and economize their insurance budget by giving individualized coverage options tailored specifically to their families.
Frequently Asked Questions On Medical Insurance Cover
What are the benefits of a Medical Insurance Cover?
  1. Having a health insurance policy covers you with the consultation fees or visiting a doctor. It is the first benefit you will have when you buy a health insurance policy.
  2. In case, you are referred to specialists where the consultation fee is higher and need to go for monthly checkups, your policy will cover you with all the charges.
  3. In the event, you are hospitalized as a result of some serious disease or illness, your insurer will meet all the hospitalization expenses
  4. Usually, the insurance companies cover the cost of drugs recommended by the physician. This may include the medicines obtained from the hospital’s pharmacy, or from a chemist accredited by the insurance company.
  5. A health insurance policy typically covers the costs associated with lab tests recommended by the doctor before starting the treatment or analyzing the problem.
  6. Some insurance companies include an ambulance benefit.  In this event, the insurance company provides an ambulance to take you to the hospital in case of an emergency.
  7. Health Insurance premiums are tax-deductible and this reduces your taxable income thus your overall tax burden reduces.
Types of medical insurance covers in Kenya?
  • Inpatient cover

Inpatient cover refers to policies that provide compensation for costs associated with hospitalization. This cover is typically more expensive than other types of cover because, in addition to the direct costs of treatment, it also covers policyholders from the liabilities associated with accommodation costs in the medical facility. Impatient covers come into effect when the policyholder is admitted to the hospital.

  • Outpatient cover

The outpatient cover is the most common type of health insurance cover. In this case, a policyholder accesses health services in a hospital or clinic accredited by the insurance company and after receiving treatment the policyholder does not remain resident in the health facility. Outpatient covers tend to be cheaper than inpatient covers because all the costs incurred are treatment-related. It does not have the accommodation component that usually inflates the cost of outpatient covers.

  • Maternity cover

This cover is usually included as an enhancement of a basic health insurance policy. Maternity cover usually meets the costs of hospitalization, including delivery and any eventualities such as congenital illnesses that may result from the pregnancy.

How to make a medical insurance claim

Medical insurance is unique in that health insurance cover can be claimed in bits as needs arise, as opposed to other covers where you can only make one claim. When it comes to claims, here is how the claims process works.

  1. Claim as you go

Health insurance claims are made when you visit a hospital access medical services. When you visit a hospital to access treatment, the insurance company will pay for your treatment based on the cover limits of your policy. You can make claims as many times as you need to provided you have not exceeded your limit

  • Copayment

Most insurance companies will have a copayment policy on their cover. This works a bit like “excess” in the motor insurance cover. What this entails is that each time you visit a health facility, you will have to pay a fixed amount to the hospital. The specific amount varies from hospital to hospital and also varies according to specific policy. The goal of copayment is to discourage frivolous visits to healthcare institutions.

  • Exclusions

The third issue you need to bear in mind is that health insurance usually comes with certain exclusions. These exclusions may include some medicines and procedures that do not meet the threshold for services that can be insured against. The most common exclusions are cosmetics procedures, food supplements, and elective procedures.

What Are The Requirements To Take Out A Medical Insurance Cover?
• A copy of your national identification card (ID)
• A duly completed proposal form will be generated from the website of the insurance of choice
• A schedule of the items to be insured under each category and their total values, whether household goods e.t.c
• Nature of the building construction and its location
• In case of jewellery being insured, a valuation certificate for the jewellery

Get contacted by one of our Medical Insurance experts

We at Edenbridge Capital have partnered with the best insurance companies in Kenya to bring you the best, favorable and affordable insurance covers tailor made to suit your needs. Our team works around the clock to ensure that we cater to your needs. We are ready to offer advice and options that suit your needs when choosing a medical insurance cover in Kenya.
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