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Affordable Medical Coverage in Kenya

The insurance sector in Kenya is booming. There are several insurance companies selling health/medical insurance packages. Some are well established while others are insurtech startups. Choosing the best company that offers affordable medical coverage in Kenya can be challenging and time-consuming. However, with the right information at your disposal, a rather difficult task becomes simple.

On the 12th December 2018, President Uhuru Kenyatta declared Universal Health Coverage (UHC) to be a national priority in Kenya, as part of his ‘Big Four Agenda’ for national sustainable development. Universal health coverage is a government’s initiative to provide quality health services to all citizens regardless of their income status. Currently, Kenya is not yet among the countries that provide universal health coverage around the world. So, is healthcare free in Kenya? In public hospitals, healthcare is free for some select services such as in-patient treatment, maternity care, and simple diseases such as flu and common cold.

Things to Consider before Buying Affordable Medical Cover in Kenya

Different insurance companies have different policies governing their activities. You might want to consider which policies you are comfortable with. Some other things to consider include the following:

Family Health Concerns and Needs

If you want to buy medical cover for your family, it is important to consider their current concerns and needs. These include age, present ailments if any, and the family’s medical history.

Medical Check-Up

An ideal medical cover should insure you for a free medical check-up if required at inception of the cover or renewal time. This helps to reduce extra costs involved in obtaining a medical cover.

Considerations during Renewal

The best health insurance should offer a renewal option beyond the retirement age. This is because the old tend to suffer from diseases and ailments more than the young. A health policy offering senior age coverage will be ideal.


It is important to consider how much you are willing and able to spend on health insurance. Also check to see that you get the best deal for your budget. If you choose the wrong policy, you might end up paying a lot of money and yet fail to receive essential health services.

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Consider Key Maternity Benefits

If you are a woman looking for medical cover, it is important that you buy health insurance that offers maternity benefits. Consider the waiting period applicable for claiming maternity expenses. It should also cover outpatient expenses.

Benefits and Cover Limits

It is important to consider the benefits that come with a particular medical cover before making a choice. Also, the cover limit you choose should be driven by health concerns. If you choose a lower limit cover, it might end up being depleted fast due to the rising standards of health care.

Post Hospitalization Aspects

You will also incur some costs after hospitalization to cater for follow up with your doctor, for medicines, etc. Your medical cover should cover these aspects.


Affordable Medical Coverage in Kenya

Upon considering the above factors, you will be in a better position to choose the best medical insurance in Kenya that best suits you. Cost is one of the issues most people take into consideration when choosing a medical cover in Kenya. How much does medical insurance cost in Kenya? The cost of medical insurance varies depending on the scheme as shown below. The following are the most affordable medical insurance covers in Kenya:

NHIF Medical Insurance Cover

The National Hospital Insurance Fund (NHIF) is the largest medical insurance scheme in Kenya operated by the government. It serves individuals, SMEs, families, and corporates. The NHIF scheme covers medical costs for Inpatient, Outpatient, Dental, Renal, Optical, and Maternity. The scheme has no limitations for pre-existing medical conditions, no cut off age for new members or those renewing their membership, and no waiting periods for most NHIF benefits.

If you are self-employed, you will need to make a contribution of KSh 500 per month to cover you and your entire first family. On the other hand, the insurance premium rates for salaried individuals range between KSh 150 and KSh 1700 per month.

NHIF offers a wide range of benefits to its members. These include consultation, operating theatre charges, nursing care, radiology services, laboratory and investigation, physiotherapy services, prescribed drugs/ medications and dressings, and hospital daily charges. Other benefits are health and wellness education, family planning/midwifery/post-natal services, renal dialysis services, treatment of sexually transmitted diseases, etc.

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Avenue Health Medical Insurance

The Avenue health medical cover is available for groups only. Avenue has more than 20 locations in Kisumu, Kajiado, Nairobi, Thika, Nakuru, Eldoret, and Mombasa. It allows members to seek treatment in any of these facilities. Avenue’s option for inpatient covers from as low as KSh 100,000 to KSh 1,000,000.

APA Afya Nafuu Medical Insurance Cover

Afya Nafuu medical cover is from APA Insurance Kenya. The medical insurance plan covers inpatient, outpatient, maternity, dental and optical, last expense cover, and personal accident cover. Benefits include accommodation in wards, HDU or ICU during your stay in hospital, drugs and dressings, any doctor related charges such as those of anesthetists, surgeons, physicians, and consultations, etc. Those eligible for cover include children between the age of 1 month and 17 years and adults between the age of 18 and 80 years. Afya Nafuu medical cover rates for maternity ranges from Ksh 50,000 to Ksh 150,000, Ksh 10,000 to Ksh 30,000 for dental and Ksh 10,000 to Ksh 30,000 for optical cover. Co-pay per head at their hospitals/clinics is Ksh 500.

BRITAM Afya Tele Medical Insurance Cover

BRITAM is a popular insurance company that offers general, life, and medical insurance. The BRITAM Afya Tele Insurance covers low-income earners in organized groups with a minimum of 10 principal members. However, it is restricted to only one spouse per policy but can include as many children as they are in the family. It covers outpatient, inpatient, maternity, etc. Britam insurance medical cover rates in Kenya for inpatients are KSh 200, 000 and KSh 300, 000 and maternity limits of KSh 20, 000 and KSh 30, 000. Those eligible for cover are children between 30 days, young adults above 18 years up to 24 years only if they are students. The applicant and spouse should be between 18 years and 65 years at entry.

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CIC Afya Bora Health Insurance Plans

The CIC Afya Bora Health Insurance plan is available to organized and registered groups like SACCOs, SMEs, MFIs, and corporates. The cover provides in-patient and outpatient benefits for a family of M+6 (principle and 6 additional members) for a premium of KSh 35, 000 per family. This is applicable for a family of any size to a maximum of 7 members. You will pay KS 4,500 for any additional child. This medical cover includes an inpatient limit of KSh 250, 000 and outpatient limit of KSh 50, 000 shared by the entire family. In case the principle dies, CIC medical insurance cover will provide the last expense benefit of KSh 50, 000.

UAP Afya County Medical Insurance

The UAP Afya County medical cover accommodates members from age of birth to 65 years old. Old or existing members can renew their membership till the age of 70 years. The UAP medical insurance covers in-patient, outpatient, and maternity medical costs. It also covers pre-existing conditions and chronic conditions after a 1 year waiting period. You can also buy an optional rider for maternity insurance. For inpatient covers, you can choose from four cover limits: KSh 100, 000, KSh 250, 000, KSh 500, 000 and KSh 1 million. On the other hand, you can choose from three cover limits for outpatient covers: KSh 25, 000, KSh 40, 000 and KSh 50, 000.

Final Thoughts on Affordable Health Care in Kenya

The existence of several health insurance companies in Kenya makes it challenging to choose an ideal cover. Before making a choice, make sure you compare quotes online, talk to trusted insurance agents and company representatives, and ask for referrals. With this, you will be in a better position to make an informed decision.

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