WHAT IS KPSA Medical Cover
Scope of Cover Inpatient Cover (Primary Cover)
- Hospitalization costs net of NHIF rebate
- Bed charges – inclusive of ICU & HDU charges, operating theatre cost
- Doctor’s fee and Surgeon/Anaesthetist fee
- Diagnostic Procedures, Dressings, Pathology, X-ray, MRI Scans
- Inpatient day case procedures
- Inpatient Physiotherapy, Radiotherapy and Chemotherapy
- Cover for treatment abroad if treatment unavailable locally
- Emergency Road and Air Evacuation covered up to overall limit
- Declared and Newly diagnosed Pre-existing, Chronic and HIV/AIDS conditions covered up to Kshs 300,000/= within the inpatient limit on full disclosure at the time of joining subject to one year waiting period.
- Congenital conditions covered up to Kshs 100,000within sub limit of pre-existing, chronic and HIV/AIDS
- Post hospitalization treatment of Kshs 50,000/= within the inpatient limit up to a maximum of 3 weeks after discharge.
- First Emergency caesarian section covered up to Kshs 150,000/= within the inpatient limit.
- Inpatient non-accidental dental cover of Kshs 50,000/= per family per annum within the inpatient limit
- Inpatient non-accidental optical cover of Kshs 75,000/= per family per annum within the inpatient limit
- Lodger fee for a parent guardian accompanying below 8 years to hospital will be covered
- Bed limit Entitlement is a general ward bed for limits below 2 Million an Standard Private room for limits of 2 Million and above.
Scope of Cover Outpatient Cover
- Doctors Consultations Fee and specialist’s fees
- Covers Surgeons, Physicians and anaesthetists fees, operating theatre charges
- Covers Dispenses drugs & dressings
- Covers Diagnostic Procedures; -x-rays, ECG, encephalogram, audiogram, radiotherapy & chemotherapy
- Day care Procedures under local anaesthesia
- Consultation fees for general practitioner Pre-existing, Chronic conditions and HIV/Aids covered up to full Outpatient benefit
- Free Outpatient dental cover of Ksh 20,000/= per family per annum
- KEPI recommended vaccines Only
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