Health Insurance

 

 

What is Health Insurance?

Health Insurance, also known as Bima ya Afya in Swahili , is a form of insurance which covers the expenses incurred on medical treatment and hospitalization. It covers the policyholder against any financial constraints arising from medical emergencies. In case of sudden hospitalization, illness or accident, health insurance takes care of the expenses on medicines, oxygen, ambulance, blood, hospital room, various medical tests and almost all other costs involved. By paying a small premium every year, you can ensure that any big medical expenses, if incurred, will not burn a hole in your pocket. The plan can be taken for an individual or for your family as a Family Floater Health Insurance Plan.

Affordable Insurance plans for your loved ones

  1. Health Insurance for Corporate Clients
  2. Health insurance for Individuals
  3. Health Insurance for Families

Major Benefits in a Health Insurance Policy

Cashless facility

Each health insurance company ties up with a large number of hospitals to provide cashless health insurance facility. If you are admitted to any of the network hospitals, you would not have to pay the expenses from your pocket. In case the hospital is not part of the network, you will have to pay the hospital and the insurance company will reimburse the costs to you later.

Pre-hospitalization expenses

In case you have incurred treatment costs for the ailment for which you later get admitted to a hospital, the insurance company will bear those costs also

Hospitalization Expenses

Costs incurred if a policyholder is admitted to the hospital for more than 24 hours are covered by the health insurance plan.

Post-hospitalization expenses

Even after you are discharged from the hospital, you will incur costs during the recovery period. Most health policies will cover the expenses incurred after hospitalization.

the costs incurred for these treatments also.

Ambulance Charges

In most cases the ambulance charges are taken up by the policy and the policy holder usually does not have to bear the burden of the same.

In-Patient Hospitalization Expenses

  • Room, Boarding expenses
  • Intensive Care Unit bed charges
  • Doctor’s fees
  • Nursing Expenses
  • Maternity Expenses
  • Surgical Fees, Operation Theatre Charges, Anesthetist, Anesthesia, Blood, Oxygen and their administration, Physical Therapy
  • Prescribed Drugs and medicines consumed on the premises
  • Investigation Services such as Laboratory, X-Ray, Diagnostic tests
  • Dressing, Ordinary splints and plaster casts
  • Cost of Prosthetic and other devices- that are used intra operatively during a Surgical Procedure, if recommended by the attending Medical Practitioner.
  • Pre-Hospitalization Expenses

The Medical Expenses incurred during the Policy Period, for the period as specified in the Schedule to this Policy immediately before the Insured Person was hospitalized, provided that:

  1. Such Medical Expenses were incurred for the same condition for which the Insured Person’s subsequent Hospitalization was required, and
  2. There is a valid claim admissible under (In-patient Hospitalization Expenses) of the Policy.
  3. Post-Hospitalization Expenses

The Medical Expenses incurred during the Policy Period, for the period as specified in the Schedule to this Policy, immediately after the Insured Person was discharged following Hospitalization, provided that:

  1. Such Medical Expenses were incurred for the same condition for which the Insured Person’s earlier Hospitalization was required, and
  2.  There is a valid claim admissible under (In-patient Hospitalization Expenses) of the Policy.

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