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UAP AFYA IMARA SENIORS


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Choose Father insurance


Minimum: 65 Maximum: 80




Choose Mother insurance


Minimum: 65 Maximum: 80




Choose Children insurance


Minimum: 1 Maximum: 18
Number of children:

TOTAL PREMIUM

see what is covered

Bed limits (net of NHIF rebate)

For a limit of Ksh. 500,000: General Ward bed is covered

For a limit of Ksh. 1,000,000: General Ward bed is covered

For a limit of Ksh. 3,000,000: Standard Private room is covered

For a limit of Ksh. 5,000,000: Private room Ensuite is covered

 

Funeral expenses per member

For a limit of Ksh. 500,000: It is Covered up to Ksh. 50,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 50,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 50,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 50,000

Non-excluded pre-existing chronic conditions on full disclosure at the time of joining (two years waiting period)

For a limit of Ksh. 500,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 250,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 300,000

 

Newly diagnosed chronic conditions excluding cancer shall be covered up to the full cover limit in the first year of diagnosis.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 250,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 500,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 1,000,000

 

Post-hospitalization treatment related to cause of preauthorization on reimbursement. Benefit limited to the first 3 weeks after discharge.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 15,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 20,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 20,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 30,000

 

In patient non-accident related eye treatments excluding surgery for refractive errors and laser treatment after one year waiting period.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 75,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 75,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 100,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 100,000

 

In patient non-accident related dental surgery/treatment after six months waiting period.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 20,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 30,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 40,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 50,000

 

Gynecological surgery after one year waiting period.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 200,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 350,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 350,000

 

Organ transplantation after two years waiting period. Cost of donor or securing the organ is excluded.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 250,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 500,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 500,000

 

 

Internal and external surgical implants, appliances, joint replacements and prostheses (excluding dental fixtures)

For a limit of Ksh. 500,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 400,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 600,000

 

Psychiatry and psychotherapy

For a limit of Ksh. 500,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 250,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 300,000

 

Non-excluded Pre-existing cancer after 2 years waiting period or newly diagnosed cancer after one year waiting period from the time of joining.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 250,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 350,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 500,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 500,000

 

Illness related reconstructive/plastic surgery from the third year of cover (Excluding cosmetic, obstetrics and gynecology related)

For a limit of Ksh. 500,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 150,000

 

Non accident related maxillofacial surgery. Excluding routine dental surgery and dental fixtures.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 200,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 300,000

 

Congenital defects and genetic disorders after one year of cover.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 150,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 200,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 250,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 250,000

 

HIV / AIDS and related conditions after one year of cover.

For a limit of Ksh. 500,000: It is Covered up to Ksh. 200,000

For a limit of Ksh. 1,000,000: It is Covered up to Ksh. 200,000

For a limit of Ksh. 3,000,000: It is Covered up to Ksh. 300,000

For a limit of Ksh. 5,000,000: It is Covered up to Ksh. 500,000

 

 

General Conditions

1. All illness claim have a 28 days waiting period.

2. Non accidental surgical claims have a 60 days waiting period.

3. Admission by doctors not in the panel is subject to 20% co-payment.

4. Joining age 65 to 80 years.

5. Cover on per person basis.

6. Every member must undergo a medical Checkup and submit report to UAP.

7. Cover subject to written acceptance by UAP Insurance after review of medical report.

8. Referrals shall be to India and South Africa Only.

9. Road evacuation shall be provided for under the inpatient cover.

10. Air evacuation shall be provided for persons whose cover limit is 1 million and above.

11. All pre-existing conditions have a two years waiting period.

 

Exclusions

1. Illness claims incurred within the first 28 days of cover.

2. Surgical claims incurred within the first 60 days of cover.

3. Amounts recoverable from other insurances such as NHIF, GPA

4. Expenses where material information is withheld or misstated.

5. Benefits not specified in the brochure and policy.

6. Treatment by any other than a certified medical practitioner.

7. Expenses incurred in connection with active participation in riots, civil unrest etc.

8. Self-inflicted injury and attempted suicide.

9. Medical costs due to experimental treatment.

10. Professional and hazardous sports activities.

11. Cosmetic Surgery.

12. Outpatient dental and optical claims.

13. Vaccines.

14. Homeopathy, chiropractic treatment, acupuncture, herbal medicine and treatment.

15. Experimental treatment.

16. Cosmetic surgery.

17. Infertility.

18. Medical bill incurred at a non-appointed facility.

19. Alcoholism, drug abuse and related ailments.

20. Treatment outside the approved and or recommended service provider.

21. Dialysis for management of a long term ailment.



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