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Imagine this: you’ve just been admitted to a local hospital, or perhaps it’s a family member, and you are presented with a bill you can’t afford. What do you do? While most people would panic, you will likely stay calm if you have the best health insurance in Kenya.
Some of Kenya’s best health insurance providers include NHIF, CIC Group, Britam, Old Mutual, AIG Insurance, Jubilee Insurance, AAR Insurance, Madison Group, KCB Bank, APA Insurance, Equity Group, and Safaricom.
Some of these health insurance providers offer just one policy. In contrast, others offer multiple options to suit different family health needs. But as you can tell, they aren’t Kenya’s only health insurance providers. There are many others, but we can’t cover them all.
We had to settle on the best in terms of affordability, reliability, and service scope. This guide will help you understand why health insurance is essential, how to find the best health insurance provider, and the types of coverage, among other things.
Here’s what we plan to cover:
- Why do you need health insurance in Kenya?
- What are the various types of health insurance covers?
- How do you choose the best health insurance in Kenya?
- How much does health insurance cost in Kenya?
- Which is the best health insurance in Kenya?
Let’s jump into it!
In a hurry? Below is a quick guide to the best health insurance companies in Kenya:
Top 12 Best Medical Insurance Companies in Kenya
| – | Insurance Provider | Health Insurance Cover | Starting Rates (Ksh) | Inpatient Coverage Limit (Ksh) |
| 1. | NHF | UHC Supa Cover | 500 per month | 100,000 plus |
| 2. | CIC Group | Afya Bora | 32,000 per year | 250,000 |
| 3. | Britam | Britam Essential 1 | 9,0001 per year | 5 million |
| 4. | Old Mutual | Afya Imara Family | 32,257 | 1 million |
| 5. | AIG Insurance | Hospital Cash | – | Depends on hospital |
| 6. | Jubilee Insurance | Cover Bora | 6,200 | 250,000 |
| 7. | AAR Insurance | Enhanced Medical Cover | 6,075 | 1 million |
| 8. | Madison Group | Better Life Budget | 13,000 | 1.5 million |
| 9. | KCB Bank | Simba Health | – | – |
| 10. | APA Insurance | Afya Nafuu | 8,900 | 2 million |
| 11. | Equity Bank | Equihealth | 15,000 | 300,000 |
| 12. | Safaricom | Linda Jamii | 12,000 | 290,000 |
Why Do You Need Health Insurance in Kenya?
There are several reasons why everyone should have health insurance in Kenya, and they include the following:
a) Inpatient cost coverage
Health insurance comes to your rescue when you or a covered family member is admitted to a recognized hospital. In such a case, it caters to a big part of (if not all) inpatient-related charges such as consultation, treatment, doctor’s fees, nursing care, bed charges, diagnostic laboratory services, medical prescriptions, surgery, and daily hospital charges.
Frankly, these costs can be overwhelming without medical insurance.
b) Outpatient cost coverage
You don’t have to be admitted to a hospital to use health insurance. You can also use it for outpatient costs, such as consultations with a general practitioner, radiology, examination, drugs, physiotherapy, immunization/vaccines, antenatal and postnatal, and counseling services.
c) Maternity service cost
Most health insurance policies also cover maternity costs, which include specialist consultation, family planning, childbirth, theater charges, prescription, radiology examination, and laboratory diagnosis.
d) Specialized care coverage
Health insurance also comes in handy when dealing with special medical cases, such as Renal dialysis, oncology, radiology, prosthesis, and psychiatric hospitalization.
e) Emergency care services
You can also count on some health insurance coverage for emergency help, such as road ambulances, which take care of onsite evacuation, hospital transfers, and other related costs.
f) Overseas treatment
You don’t just need health insurance to be treated locally but overseas, too. Even NHIF nowadays has an impressive package for overseas treatment. Some insurance companies, like Liberty Health, even cater to accommodation and transfer services.
g) Cheaper cost
While you need to make regular contributions to enjoy health insurance, the cost is nothing compared to what you would pay without insurance. For example, NHIF pays up to Ksh 100,000 for covered members who contribute only Ksh 500 per month.
Just ask yourself, how many months will it take you to contribute Ksh 500 per month to hit Ksh 100,000? You got your answer. It’s undeniably cheaper to pay for health insurance than in cash.
h) Peace of Mind
Health insurance gives you the mental peace to soldier through a gruesome health condition or taxing treatment. Your family does not have to endure extra financial pressure to raise the money.
Types of Health Insurance in Kenya
Below are the most common types of health insurance plans in Kenya:
- Inpatient cover – Inpatient insurance covers associated hospitalization charges, including consultation, bed charges, lab diagnostics, nursing care, surgery, and drug prescriptions.
- Outpatient cover— Outpatient insurance covers outpatient charges, including consultations, drug prescriptions, laboratory tests, and radiology.
- Maternity coverage —As the name suggests, maternity coverage is enhanced coverage for mothers and expectant mothers. It covers consultation, hospitalization, delivery, and other maternity-related costs.
- Low-cost health coverage—Some insurance companies offer low-cost premium plans that target low-income earners in the country. However, these plans provide limited service coverage; an example is Safaricom’s Linda Jamii.
How to Choose the Best Health Insurance in Kenya
Choosing the best health insurance coverage in the country is never easy, as you have to consider several things. They include the following:
a) Coverage and Benefits
Medical insurance covers aren’t the same. They don’t offer the same coverage. Some provide better coverage than others. So, choosing an option that matches your individual and family health needs is essential.
Look for extra benefits such as maternity cover, overseas cover, renal dialysis, oncology benefits, surgical benefits, radiology benefits, and emergency care, among others.
b) Premium Contributions
The premiums are the amounts you contribute periodically to sustain your membership and eligibility. The amount varies between insurance providers and plans. So it’s essential to consider an option you can afford.
Some of the cheapest medical insurance in Kenya include:
- NHIF UHC Supa Cover (starting Ksh 500 per month)
- AAR Enhanced Medical Cover (starting from Ksh 6,075)
- Jubilee Cover Bora (starting from Ksh 6,200 per year for individuals)
- APA Afya Nafuu (starting from Ksh 8,900 per year)
- Britam Essential 2 (starting from Ksh 8,127 per year)
- Safaricom Linda Jamii (starting from Ksh 12,000 per year)
- Madison Better Life Budget (starting from Ksh 13,000 per year)
c) Coverage Limits
Your health insurance should cover you fully. For example, suppose you estimate that your family could average Ksh 500,000 a year in medical expenses. In that case, it doesn’t make sense to go for a cover with a limit of Ksh 200,000. You should instead go for Ksh 500,000 or more.
d) Hospital Networks
Most insurance companies are affiliated with specific hospitals. You have to go to these hospital affiliates if you want the insurance to cover you. For that reason, ensure the policy you go for allows you to get coverage at a top hospital you prefer.
e) Reputation
The insurance company you go for should have a good reputation. What are people saying about it? Don’t just trust everything insurance agents tell you, as they are often after commission.
f) Waiting Time
Typically, it takes time to make the first contribution to a policy and become eligible for coverage. Ensure you get clarification about this from your insurance provider. The NHIF, for example, has a 2-month waiting period for new members, which is quite reasonable.
g) Copayments & Deductibles
Copayments refer to the out-of-pocket amount you pay for consultation partly as your health insurance takes care of the rest. On the other hand, deductibles are the fixed amounts that insurance companies promise to pay when setting your bill, which means you must pay the rest out of your pocket. Good insurance should have a favorable copayment and deductible policy.
h) Regulation
The health insurance company you go to should be regulated. The IRA (Insurance Regulatory Authority) regulates local insurance companies.
i) Customer Support
You should contact your insurance company when you need to submit a claim or clarify something. If their customer support desk is unreliable, you’ll likely struggle to settle your bills when in need.
How Much Does Health Insurance Cost in Kenya?
The cost of health insurance in Kenya varies from provider to provider and depends on the type of coverage. For example, the NHIF UHC Supa Cover, arguably the cheapest health insurance, costs Ksh 500 per month for self-employed and self-sponsoring Kenyans.
Meanwhile, Safaricom’s Linda Jamii insurance cover costs Ksh 12,000 per year but offers a coverage limit of Ksh 290,000.
Which Is the Best Health Insurance in Kenya?
Below are 12 of the best health insurance covers in Kenya and their offers:
1. National Hospital Insurance Fund (NHIF)
Generally, the National Hospital Insurance Fund covers over 90% of Kenyans with health insurance. It’s arguably the most affordable health insurance in the country. With NHIF comes the Universal Health Coverage (UHC) Supa Cover.
The UHC Supa Cover costs only Ksh 500 per month for self-employed and self-sponsored Kenyans and their families. It generally offers inpatient, outpatient, maternity, oncology, renal dialysis, radiology, surgical, and mental and behavioral health coverage. The Supa Cover can pay up to Ksh 100,000 or more at NHIF-recognized facilities.
Other insurance plans by NHIF include Linda Mama, Edu Afya, and Enhanced Scheme. Linda Mama is a free one-year maternity cover for pregnant women. At the same time, Edu Afya is an NHIF cover for NEMIS-registered students in public secondary schools.
Meanwhile, the Enhanced Scheme is an NHIF enhancement that covers civil servants, county governments, parastatals, and police service, among others.
2. CIC Health Insurance
CIC Group offers several insurance plans to different sets of people, and here are the most popular ones:
- Afya Bora – Afya Bora covers families of up to 6 members, offering an inpatient coverage limit of up to Ksh 250,000 and outpatient coverage of up to Ksh 50,000. The yearly premium is Ksh 32,000.
- MediSure – MediSure also protects the family against illnesses and accidents. It is available in 6 packages with a Ksh 300,000 – Ksh 5 million coverage limit.
- SME Medipack – SME Medipack covers SME business owners and their dependents, offering an inpatient cover limit of Ksh 300,000 – Ksh 5 million, depending on the package.
3. Britam Health Insurance
Britam offers health insurance under the Milele Health Plan, which features a set of four plans which are as follows:
- Milele Essential 1 – Britam Essential 1 is best for families on a Budget. Its premium starts from Ksh 9,001, and it offers an inpatient coverage limit of Ksh 300,000 – Ksh 5 million, depending on the package. The disadvantage is that it doesn’t offer coverage for critical illnesses. It, however, provides coverage on telemedicine, online pharmacy, and funeral expenses.
- Milele Essential 2 – Britam Essential 2 has the same coverage as Essential 1. The only difference is that its maximum coverage limit is Ksh 2 million, resulting in slightly cheaper premiums (starting from Ksh 8,127).
- Advantage Plan – Britam Advantage offers critical illness coverage, among other advantages you won’t find on Milele Essential plans. The plan even covers preexisting, congenital, and chronic illnesses. Its premiums start at Ksh 17,332 and offer a maximum coverage of Ksh 10 million.
- Premier Plan – Britam Premier Plan offers the same provisions as Britam Advantage. Unlike Britam Advantage, it doesn’t cover preexisting, congenital, and chronic illnesses. Its premiums start at Ksh 11,099.
4. Old Mutual Health Insurance
Old Mutual is one of the country’s oldest and most reliable insurance companies. They offer an array of health insurance packages, which include:
- Afya Imara Family – The Afya Imara Family covers families against inpatient and outpatient charges. Moreover, you can enjoy cash-outs of up to Ksh 750,000 in case of critical illnesses. The cost of the plan starts from Ksh 32,257 per year.
- Afya Imara Junior – Afya Imara Junior covers kids up to 18 years or up to 21 years who are schooling. They offer inpatient cover limits of 500k – 1 million.
- Afya Imara Senior – Afya Imara Senior covers senior adults 65 – 80 years, allowing an air evacuation limit of Ksh 1 million, among other benefits.
- Afya Imara Executive – This policy offers high coverage limits to individuals and their families, as well as worldwide coverage (overseas treatments) and private doctors.
5. AIG Health Insurance
AIG Insurance is reputable for offering some of the best insurance policies in the country. Today, they offer the Hospital Cash health coverage that offers daily cash benefits to a covered member hospitalized for three or more days. Not only does it cover hospitalization due to sickness but also due to accidents.
6. Jubilee Health Insurance
Jubilee Insurance offers an array of affordable health insurance plans, and the most notable ones are:
- Cover Bora – Cover Bora is an affordable way for families to cover. It offers a coverage limit of Ksh 250,000 for inpatient services, Ksh 40,000 for maternity costs, and Ksh 20,000 for the last respect. The Cover Bora Jubilee Insurance medical cover rates start from Ksh 6,200 for individual policyholders and Ksh 12,600 for families.
- J-Care – J-Care is a family health cover that offers a coverage limit of Ksh 10 million for inpatient services.
- J-Junior – J-Junior is a standalone cover for kids up to 17 years. Some of its provisions include Pediatric visits, telemedicine consultations, checkups, and outpatient and inpatient services.
- J-Senior— J-Senior targets senior citizens (above 65 years). It offers coverage against chronic conditions and hospice care with a coverage limit of Ksh 10 million.
- Critical Illness Cover – This coverage offers financial protection against critical illnesses with limits of Ksh 50,000 – Ksh 150,000, depending on the plan.
- Care and Health – Care and Health is an international health coverage that covers international travel, offering limits of up to $4 -5 million.
7. AAR Health Insurance
AAR Insurance is famous for its Enhanced Medical Cover for individuals and families. This coverage covers all family members up to 64 years. It comes in 6 plans: Cover Me, Bronze, Silver, Silver Plus (+), Gold, and Platinum.
AAR medical insurance rates in Kenya:
AAR premiums start from Ksh 6,075 for Cover Me to Ksh 289,090 for Platinum.
Meanwhile, the coverage limits for inpatients start at Ksh 1 million for Cover Up and reach Ksh 40 million for Platinum. On the other hand, the coverage limit for outpatient starts from Ksh 50,000 for Cover Me to 250,000 for Platinum.
Furthermore, you enjoy coverage limits of up to Ksh 150,000 – Ksh 5 million for cancer and chronic illnesses, Ksh 5,000 – Ksh 25,00 for dental and optical care, Ksh 50,000 – Ksh 500,000 maternity benefits, and Ksh 50,000 – Ksh 200,000 last respect.
Other notable health insurance plans by AAR Insurance are AAR Unlumicare and ShwAARi. AAR Unlumicare is family-tailored health insurance that provides comprehensive coverage for inpatient, outpatient, maternity, dental, psychiatric treatment, and medical prescriptions, among many other services.
ShwAARi, on the other hand, is a one-limit annual health cover for individuals and families that covers inpatient, outpatient, emergency evacuation, dental, optical, drug prescription, and ambulance services.
8. Madison Health Insurance
Madison Group is known for two health insurance plans: Madison Better Life and Better Life SME Insurance. For one, Madison Better Life is a comprehensive cover for individuals and families up to 18 – 64 years old.
Madison Better Life features Better Life Budget, a low-priced package whose premium starts at Ksh 13,000 to about Ksh 89,000. The coverage offers a limit of Ksh 500,000 – Ksh 1.5 million for inpatient costs and Ksh 50,000 – Ksh 100,000 for outpatient charges.
Furthermore, it provides a maternity cover limit of Ksh 100,000 – Ksh 150,000 and a cancer and critical illness coverage limit of Ksh 150,000 – Ksh 300,000.
Meanwhile, Better Life SME insurance caters to the needs of SME business owners and their families. The policy offers inpatient coverage of Ksh 200,000 – Ksh 5 million, outpatient coverage of Ksh 40,000 – Ksh 250,000, optical coverage of Ksh 10,000 – Ksh 50,000 and dental benefits of Ksh 10,000 – Ksh 50,000.
9. KCB Bank Health Insurance
KCB Bank doesn’t just offer banking services; it is also a leading insurance provider. Here are their notable health insurance covers:
- Simba Afya – Simba Afya is a comprehensive cover that offers inpatient and outpatient benefits to KCB customers and their dependents.
- Simba Health – Simba Health is similar to Simba Afya, which enjoys higher limits.
- Simba Health Junior – Simba Health Junior covers kids up to 24 years. It takes care of inpatient, outpatient, checkups, and immunization, among other costs. It offers an outpatient limit of 50k – 250k and an inpatient limit of Ksh 500k to Ksh 8 million.
- Simba Health Senior – Simba Health Senior covers senior adults aged 60 – 85 years, offering an inpatient limit of Ksh 500k – Ksh 5 million and outpatient limit of 100k – 300k.
10. APA Health Insurance
APA Insurance is another leading provider of multiple health insurance plans. The most notable ones are as follows:
- Afya Nafuu – Afya Nafuu is an affordable family health cover catering to members between 38 weeks and 80 years old. It offers maximum yearly benefits of up to Ksh 2 million. Its premium rates start from Ksh 8,900.
- Jamii Plus – Jamii Plus provides comprehensive health insurance coverage for individuals and their families. It offers outpatient, maternity, optical, and dental coverage. The policy provides an inpatient coverage limit of Ksh 500,000 – Ksh 10 million per year. Its premium rate starts at Ksh 18,480.
- Cancer Care (or Femina) – Cancer Care offers coverage against cervical and breast cancer. The coverage provides cash benefits of Ksh 250,000 – Ksh 500,000.
11. Equity Group Health Insurance
Equity Group Holdings offers three types of health insurance plans, which are as follows:
- Equihealth – Equihealth offers health coverage to individuals in registered groups (up to 10 members) and their families. Its premiums are affordable (Ksh 15,000 yearly for up to 5 family members and offer a coverage limit of up to 300k.
- Equimed – Equimed is a comprehensive cover for individuals, their families, and groups. It offers coverage limits of up to Ksh 120,000 for outpatient and Ksh 5 million for inpatient.
- Riziki Cover – Riziki health coverage is available to Equitel subscribers admitted to the hospital. It offers daily cash payouts of Ksh 400 – Ksh 800. You, however, have to use your Equitel line, averaging a monthly airtime purchase of at least Ksh 100 and M-Banking transactions of at least Ksh 1,000 (for heavy users).
12. Safaricom Health Insurance
Safaricom has partnered with different stakeholders to offer health insurance to its customers. One popular program is Linda Jamii, a collaboration between Safaricom, Changamka, and Britam.
Linda Jamii costs Ksh 12,000 per year but offers coverage of up to Ksh 290,000, which takes care of inpatient hospitalization, outpatient, maternity, and dental services, as well as funeral expenses.
Another Safaricom-sponsored health insurance coverage is M-TIBA. MTIBA allows you to separate healthcare funds from your typical MPESA funds, and you can start depositing as little as Ksh 10.
Conclusion
Above is a quick guide to finding the best health insurance in Kenya. Depending on your medical or health needs, you can choose any of the 12 options. Remember, however, to do your homework to make the right decision. After all, health is wealth, and you must protect it in the best way possible.
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