What it covers
Individual cover
For one person — inpatient, or inpatient plus outpatient. Sized to your age, health and budget.
Family cover
One policy covering principal member, spouse and children. Usually better value than separate individual covers.
Corporate / group cover
For employers covering staff. Group pricing often unlocks benefits — like no waiting periods — that individuals cannot get.
Inpatient vs outpatient
Inpatient pays when you are admitted to hospital. Outpatient pays for clinic visits, tests and medicine without admission. Many covers bundle both with separate limits.
Who needs it
- Individuals without employer cover
- Families wanting one policy for everyone
- Employers adding staff medical benefits
- Anyone wanting cover that complements SHA
What you need to apply
- National ID or passport of members
- Ages / dates of birth of everyone to be covered
- KRA PIN of the principal member
- Medical history disclosure (pre-existing conditions must be declared)
- Company registration details (for corporate covers)
Send documents on WhatsApp and we will confirm the exact list your insurer needs before you commit.
Common exclusions — the honest part
Medical covers commonly have waiting periods, exclusions for undeclared pre-existing conditions, and sub-limits for maternity, dental and optical. We show you the limits that matter for your family before you decide.
Questions people ask
What is a waiting period?
A time at the start of the policy when certain benefits cannot be claimed — maternity often has a waiting period of around 9–12 months, for example. Waiting periods vary by insurer and are one of the first things we check for you.
Does medical cover work with SHA?
Yes. Private medical cover works alongside the Social Health Authority — the private cover pays for benefits and hospitals that SHA does not reach. We can show you how the two fit together.
Are pre-existing conditions covered?
Often yes, but usually after a waiting period and only if declared upfront. Hiding a condition is the fastest way to have a hospital claim refused — declare everything and we will find the insurer whose terms suit you.