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Benefits offered under Medical Insurance

Main Benefit

A fully insured In-patient scheme.

Optional Riders

  • A fully insured out patient scheme
  • A fully insured Dental and optical cover
  • A fully insured Maternity Cover
  • Last/Funeral expense cover
  • Excess of Loss Cover

Enhanced benefits

  • Cover for Pre-existing and chronic conditions
  • Opportunistic infections of HIV conditions

Other benefits offered at a fee

  • Fund management / Scheme administration only
  • HIV management programme / administration only.

Structure of Cover

Cover can be either on a:

  • Per Family /shared limit. The family shares the cover on a first come first to claim basis until the limit is exhausted.
  • Per person basis. Each member has own limit.

Scheme Membership:

  • All Permanent Employees, aged between 18 to 65 years.
  • One Legal Spouse per principle member.
  • Own or legally adopted child from 0 months (a term baby) to 18 years (or 23 Years for a child who is a fulltime school or college students).

Scope of Cover

Coverage for Hospitalization (Inpatient Cover)

Limit of cover offered: Minimum Kshs.100,000 to a maximum 5,000,000
Inpatient cover provides for medically necessary hospital bed charges, doctor’s bills, anesthetist’s bills, operating theatre fees, ICU expenses, day surgery,physiotheraphy pharmacy, laboratory and investigations reasonably incurred by an insured member. Local road and air evacuation is also included. This cover will be on credit facility with our providers.

Outpatient

Limit of cover offered: Kshs. 30,000 to 300,000
Outpatient cover provides for medically necessary consultation fees, investigatory procedures (laboratory & radiology), referral to specialists, pharmacy and dressings Cover will be on credit facility basis with our providers and on 80% re-imbursement.

Dental

Limit of cover offered: Kshs. 10,000 to 30,000
This provides for:

  • Cost of fillings
  • X-rays.
  • Extractions including surgical extraction together with anaesthetics fees

Optical

Limit of cover offered: Kshs. 10,000 to 30,000
This provides for:

  • The cost of eyeglasses and eye testing.

Maternity

This benefit shall cover

  • Delivery fees, consultation and treatment for both mother and child only during the period of confinement in hospital.
  • Costs for miscarriages and abortions may be covered, provided they are certified by a gynaecologist as being necessary to save the life of the mother.
  • This benefit is only available to staff/spouse

Service Providers

Provider network (available on credit):

  • Jubilee has a comprehensive panel of service providers we work with across the country and in East Africa (Uganda, Tanzania, Burundi). Overseas network (available on credit):
  • Prince Aly Khan Hospital - Mumbai, India
  • Aga Khan University Hospital - Karachi Pakistan

Why should I consider Jubilee?

At Jubilee, we:

  • Guarantee confidentiality of member data and medical information.
  • Provide clear communication of scope of cover to employer/members
  • Maintain access to all the accredited hospitals
  • Audit of bills and the utilization of the scheme by members
  • Ensure prompt settlement of claims
  • Issue policy document and photo cards promptly
  • Issue quarterly expenditure statement and call for review meeting.
  • Observe the principal of Utmost Good Faith
  • Issue policy document and photo cards promptly

Unique Features of Our Medical Cover

  • Regional presence-Jubilee provides seamless and borderless coverage within East Africa region and specifically in Kenya, Uganda, Tanzania and Burundi for organisations with spread in these regions or those that require this spread of coverage
  • An all-inclusive scheme covering pre-existing, chronic and HIV conditions is available
  • Expertise and Experience
  • Financial strength
  • High rating with the healthcare providers Competitive pricing
  • Flexibility and customization-- Ability to tailor-make schemes for our clients.
  • Ability to facilitate health talks/wellness program and medical camps for our clients. Periodic comprehensive scheme analysis reports and member statements
  • 24-hour department and call centre-clients and providers are able to reach us at any time

Corporate Medical is bespoke and we provide quotation.

Download Medical Providers List (In Nairobi)

Download Medical Providers List (Out Of Nairobi)

Download Corporate Application Form

Download Corporate Claim Form

 

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