27 percent of all business insurance premiums in Kenya are paid for medical/health insurance, which makes up KSh 30 billion. With the rising cost of private medical care both in Kenya and abroad, it is no wonder that many people want to get on a health care plan. People who work for a company often get medical insurance as a benefit, but some choose to buy their own insurance.
The government also set up the National Health Insurance Fund (NHIF), which is required for everyone who works or owns a business. It is used to pay for medical costs up to a certain amount at government-owned medical facilities. For this reason, many people choose to buy a private medical plan that has a lot more money set aside for expenses.
How health insurance works in Kenya
A mandatory in-patient benefit is included in all private health insurance plans in Kenya, but this does not cover outpatient/day procedures, consultations, or medication costs. In addition, the insured can choose among outpatient, optical, dental, and maternity treatments.
When an insured person is admitted to the hospital overnight, this policy will cover the cost of everything from consultations to professional fees to bed charges to procedures and surgeries. All private medical insurance plans must include this basic level of coverage.
A day patient is defined as someone who does not need to be admitted to a hospital overnight for treatment. The insured has the option to include it in their In Patient coverage as an extra perk.
Top health insurance companies in Kenya
Kenya’s largest general and medical insurer, Jubilee, provides medical coverage for corporations, small businesses (SMEs), and individuals and families. KSh 500,000 to KSh 5 million is available to retail medical plan members, with optional outpatient coverage limitations ranging from KSh 50,000 to 150,000.
At first, AAR Insurance focused solely on medical insurance, but the company has since expanded its offerings to include personal accident coverage and a wide range of workman’s compensation policies. AAR Health Care Limited, the sister company of AAR Insurance, is well-known for its AAR patient clinics in major cities. Non-AAR clients are also welcome at these clinics. AAR’s medical plans are the most comprehensive on the market for individuals and families, and the company’s No Claims Discount program encourages people to lead healthier lifestyles.
Two things set AAR medical inpatient plans apart from others in the industry:
There is a sublimit for accidents, and there is another for illness. This is unlike the suppliers, which do not distinguish between the two boundaries. ‘
As a second advantage, there is a minor optical benefit included in the inpatient insurance plan, which is not typical among other insurers.
One of the leading general insurers, UAP has a strong medical business created initially through corporate and SME clients but has gradually expanded its retail business. Health insurance for senior adults (over 65 years old) and Junior plans (under the age of 18) are solely offered by this provider, which does not require an adult to be registered on a policy.
Individuals and families can choose from three different levels of coverage: the normal retail cover, the high-end premium option with limits of up to KSh 20 million, and the economy option, which is geared toward counties.
Resolution is a medical insurance pioneer in Kenya and the East African region. There are two tiers of service, one for the upper-middle class and the other for the lower-middle class. It offers the finest value for money choice, particularly for families. It, too, like AAR, has branched out beyond medical insurance to include auto, travel, and even home and personal injury coverage.