Medical Insurance in Kenya: What to Consider

It is very difficult to make a right and wise decision on which policy to buy when it comes to Medical Insurance in Kenya. This is truly a confusing task. Here is a guideline. Here are the five most important things you have to pay attention to. These items are also your keys to picking a policy that’s right for you:

The insurance company’s record of complaints: Every large company will have some complaints. You can obtain more information from the Insurance Regulatory Authority. Avoid companies that have a high number of unresolved complaints. Ask your agent for the phone number for the company they are marketing. If he will not give it to you, this is a warning signal! You can also look up the number in any directory available in Kenya or online. No matter what your agent says, CALL the Insurance Regulatory Authority and ascertain that the company is legit.

The limits shown on your health insurance quote: Check your quote to see if you are comfortable with the benefit levels of your Medical Insurance in Kenya. You can usually change several levels to fit your needs and budget. For example, a higher deductible will cost less each month. Also, many plans give you a choice to split your medical bills with the Insurance Company either 50/50 or 80/20 (with them paying 80%). Then they will have an amount (your stop loss) where they will take over at paying 100% of your covered bills for the remainder of the year. These deductibles and other levels start over every year in most plans. Some plans, though, have a “per cause” deductible. Such a deductible means that you will be responsible for bills up to that deductible for each accident or illness. Make sure you are aware of this distinction, so you can choose a plan that’s right for YOU! You can seek more guidance from your prospect insurance company in Kenya.

The insurance company’s rating: Ask your agent for the company’s best rating. If the company is highly rated, then the company will have literature showing their rating with an explanation of what it means. Choose only companies that have an A or A+ rating.

The limits revealed within the policy: Ask your agent for a sample of the Medical Insurance in Kenya, and then check two sections: The Benefits and The Limitations and Exclusions. Many of your benefits are actually limited in the Benefits section. For example, diagnostic testing or outpatient treatment may be severely limited. These days, you could have a serious disease such as cancer, and never go into the hospital for it. You could rack up thousands of dollars in medical bills for the diagnostic and follow-up lab tests and MRIs, and then have surgery, chemo, or radiation therapy all on an outpatient basis.

Your hospital room rate and intensive care can be limited. Your hospital room rate should be at least average semi-private and your intensive care benefit should not be tied to your room rate, but should, instead, be covered as whatever is an average ICU rate for the area of the hospital, also. Some policies limit the ICU benefit to 3 times the regular room rate, when ICU can cost you 10 or 20 times the room rate each day. A short hospital stay with a limit like this in your policy can cost you literally thousands of shillings. A long hospital stay with a limit like this in your policy could drive you into bankruptcy. yes. Even if your policy says it takes over at 100% after Ksh50,000 of covered medical bills, the important term here is “covered” medical bills. If the policy only pays three times the room rate for ICU, then the rest of the ICU bill is considered an “uncovered” charge! These terms might not make sense, so seek further guidance from your agent.

Pay the Insurance Company, Not the Agent, & Follow Up!: And lastly, make your check payable of your Medical Insurance in Kenya to the Insurance Company, and then follow up to make sure it was received. When you get your policy, check the Schedule of Benefits to verify you got the coverage you ordered, and then check to see if any special Amendments were added to your policy to exclude any of your conditions. If an Amendment exists, these conditions will always be excluded from this policy, even after the Pre-Existing Conditions Limitation expires.

With all these 5 items, they will help you which will protect you from catastrophic medical bills. Be sure to take the time to choose wisely when it comes to your Medical Insurance in Kenya!