Britam Medical Insurance & Other Cover Options

Britam Medical
The Britam corporate medical cover, also known as Mediflex, offers inpatient cover and a fund- managed outpatient cover. Our Health insurance cover provides a comprehensive and flexible cover for employees as well as their dependents.
Registered companies, NGOs, as well as Chamas with more than 10 members are eligible.
Our medical insurance cover is flexible allowing for employers to choose the expenses that will be catered for, including:
  • Routine outpatient consultation.
  • Diagnostic laboratory & radiology services.
  • Prescribed drugs and dressings.
  • Dental & optical services subject to sub-limits and terms.
  • Prescribed physiotherapy.
  • Chronic, recurring & pre-existing conditions.
  • HIV/AIDS and related conditions and ARVs.
  • Routine antenatal and postnatal care.
  • Routine immunizations.
Services and Groups Covered
 
Afya tele
Kinga ya Mkulima
Endeleza elimu
Sacco solution
 
Afyatele
AFYATELE is a unique corporate (group) medical insurance cover with an inbuilt funeral benefit.  This policy can be taken as an Organization or as registered groups with minimum a principle of 10 members. It is however restricted to only one spouse per policy. Member can include as many own children as they are in the family.
The Benefits Include:
Inpatient
a) Hospitalization bills paid directly to the hospital on the panel
b) The scope of cover extends to accommodation on general ward bed in the appointed hospital.
c) Includes Resident Doctors charges, Nursing Fee, Bed Charges pharmacy, laboratory and radiology charges.
d) Maternity and pregnancy related illnesses cover of up to Kshs 20,000 for either normal deliveries or caesarian section within inpatient limit (9 months waiting period)
e) Pre-existing and chronic conditions capped at 50%of limit.
f) Lodger charges payable for children under 5 years.
Outpatient
a) Consultation Fee- resident Doctor/ RCO
b) Laboratory Charges
c) Radiology charges except MRI
d) Pharmacy charges
e) Day case procedures.
f) Physiotherapy- Max 3 sessions
g) Dental/ Optical treatments within Limit.
 
Who is eligible for the cover?
The applicant and the spouse should be between 18 and 65 years at entry. 
Children between 30 days and 18 years automatically qualify for inclusion. Those above 18 years up to 24 years can be included only if they are students in school/college.
Waiting periods are as follows;
a) 1 month  for  all  illnesses  but  treatment as a result of  accidental causes  are  covered from commencement date.
b) 1 month waiting period on death as a result of natural causes. Death as a result of any accident is covered from commencement date
c) 9 months’ waiting period for maternity and pregnancy related treatments.
d) 1 year waiting period for surgical treatment unless surgery is as a result of an accident
For more information on this product click here to download the Afya Tele brochure, contact us online here or visit our Office at Rehani House, 5th floor, Junction of Kenyatta Avenue & Koinange Street . 
 
Kinga ya Mkulima
Kinga ya Mkulima is specially designed for small scale tea farmers that are registered with the Kenya Tea Development Agency. It can be taken as an individual or as a family and includes daily hospital benefits, medical surgery benefits as well as funeral benefits.
For more information on this medical cover, kindly contact Britam online here or visit our Office at Rehani House, 5th floor, Junction of Kenyatta Avenue & Koinange Street or  click here to download brochures in English or in Swahili. 
 
Endeleza Elimu
This is a school fees guarantee for the continuity of a pupil or student’s education, in primary or secondary school respectively, only when there is demise or accidental total and permanent disability of a parent.The cover will be administered by the school and included in the fees in order to give equal opportunity to all children.
Who is eligible for the cover?
Private schools, both primary and secondary.
How does the product work?
• This is a term insurance that insures the school fees paying parent’s life.
• The product covers annual school fees in the event of Natural and accidental death of the parent.
• It extends to cover total and permanent disability due to an accident.
• It has a fixed benefit and is renewable annually for a maximum of 4 years depending on the class the child is enrolled. The sum insured reduces with the remaining years
of school.
Below is a guide on how the cover works for different level of classes
These classes are guaranteed cover for 4 years
 
Std. 1, Std. 2, Std. 3, Std. 5, Form 1
 
These classes are guaranteed cover for 3 years
 
Baby Class, Std. 6, Form 2
 
These classes are guaranteed cover for 2 years
 
Nursery, Std. 7, Form 3
 
These classes are guaranteed cover for 1 year
 
Pre Unit, Std. 8, Form 4
 
 
How much does it cost?
The cost of the cover is 1.4% of annual school fees. This is distributed in 4 year or 8 year tranches, but reduces with the remaining years of school.
If the school chose to pay premiums annual, the premium rates shall be 1.2%.
 
Sacco Solution
This is a unique insurance product for SACCO members offering them an Inpatient, Accidental death cover, Accidental total and permanent disability cover and an inbuilt Last Expense cover. In addition, the product provides for Credit Life Insurance cover to members taking loans.
Benefits of Sacco Afya
Inpatient Cover
This is a health care plan to manage unforeseen illness or injuries that lead to hospitalization.
Accidental death and total and permanent disability cover
This provides compensation to the insured family/ beneficiary in the event of physical and visible body injury leading to death within 6 months from the date of the accident.
Last Expense
This cover provides support to cover funeral expenses following the death of the insured.
Credit Life
The credit life covers a borrower in the event of death or total and permanent disability to the extent of their bank’s financial interest in the loan (outstanding loan + interest) and the actual monthly loan repayments. Rates to be provided based on the size of the loan book
BENEFIT
OPTION 1
(COMPULSARY FOR LOANEES)
OPTION 2
INPATIENT COVER LIMIT
Chronic/ Pre-existing/ Psychiatric cases capped at 50% within IP Limit
Ksh 200,000     
Ksh 100,000
Ksh 300,000
Ksh 150,000
MATERNITY COVER LIMIT
Ksh 20,000
Ksh 30,000
ACCIDENTAL DEATH/TPD COVER
Ksh 100,000
Ksh 200,000
LAST EXPENSE COVER LIMIT
Ksh 40,000online here
Ksh 80,000
ANNUAL PREMIUM 
Ksh 3,800
Ksh 5,600
*For every extra member the premium goes up Ksh 1,400
* Option 2 any additional member KSH 2,000


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Date published: 22/09/2017
4.9 / 5 stars