| Benefits | Coverage Limit |
|---|---|
| Daily Bed Limit | Based on limits above |
| Prescription Drugs and dressings | Covered within the limit |
| Surgical Fees including Anesthesia | Covered within the limit |
| Post Hospitalization Treatment/ Reimbursement | Capped at 30,000 or 21 days whichever comes first |
| Psychiatry | Covered up to 20% of In-patient Cover |
| Accommodation costs for 1 parent staying in hospital with insured child under 12 years | Covered within the limit |
| Pre-existing & Chronic conditions including HIV- AIDS |
|
| 1st Emergency Caesarian Section | Capped at Kshs. 150,000/= Within In-patient Cover |
| Congenital Conditions for Children below |
|
| Maternity, including maternity related complications and elective caesarian section (9 months waiting period) | Capped at 50,000/= Within in-patient Cover. |
| Inpatient Dental (illness) |
|
| Inpatient Optical (illness) |
|
| Inpatient Dental (accident) | Up to the Cover Limit |
| Inpatient Optical (accident) | Up to the Cover Limit |
| HIV/ Aids and related illnesses | As indicated under Chronic Conditions |
| Funeral Expenses | 50,000 – Per family |
| Day- Surgery | Covered within the limit |
| Diagnostic tests | Covered within the limit |
| Co – payment | None |
| Circumcision medically necessitated | Kshs. 20,000 for medical circumcision for members below the age of 10 years. |
| Covid-19 | Covered within the chronic conditions sub limit for critical cases only at selected hospitals. |
| External Appliances | Covered upto Kes.80,000 within inpatient |
| Evacuation | For inpatient Kes.500,000 and 1Million Ambulance For inpatient Kes.2.5 Million and 5 Million Ambulance and Air evacuation. |