You can access the following inpatient services:

1. Pathology.
2. Diagnostic tests and procedures.
3. Radiology, radiotherapy and chemotherapy.
4. Access to personal consultant for Platinum Cover.
5. Cancer tests and consultation.
6. Dental treatment i.e., simple gum surgery, root canal treatment, pulpotomy and minor oral surgery.
7. Optical services i.e., prescribed lenses, contact lenses, dioptric power +/- 0.25 D and more, and frames.
8. Pre-natal and post-natal care.
9. Physiotherapy by a registered physiotherapist.
10. Child vaccination as provided for in the KEPI Guidelines.
11. Nutritional services and advise.

You can access the following outpatient services:

1. Diagnostic tests and procedures.
2. Radiology, radiotherapy and chemotherapy.
3. Access to personal consultant for Platinum Cover.
4. Cancer tests and consultation.
5. Dental treatment i.e., simple gum surgery, root canal treatment, pulpotomy and minor oral surgery.
6. Optical services i.e., prescribed lenses, contact lenses, dioptric power +/- 0.25 D and more, and frames.
7. Pre-natal and post-natal care.
8. Physiotherapy by a registered physiotherapist.
9. Child vaccination as provided for in the KEPI Guidelines.
10. Nutritional services and advise.

The following are required when signing up for a cover:

1. Age: Newborns from discharge up to 64 years.
2. Be a Kenyan resident.
3. KRA PIN.

Enjoy the following benefits under your cover:

1. You can only access healthcare from hospitals we’re in partnership with.
2. If an emergency leads to an admission, let us know within 24 hours.
3. Let us know of a scheduled admission at least 48 hours in advance.
4. You can now present your M-TIBA to get treatment at our partner facilities.
5. To make a claim you need to fill and sign the given claim form.
6. On applying, any prior health conditions need to be stated.

The following are not covered in your insurance plan:

1. Hearing aids.
2. Vaccinations and immunizations not recommended in the KEPI guidelines.
3. General health check-ups unless otherwise stated in the plan.
4. Venereal diseases.
5. Family planning and fertility treatments i.e., costs of treatment related to infertility and impotence.
6. Intentional self-injury, suicide or attempted suicide, drug addiction, intoxication or drunkenness.
7. Cosmetic surgery unless addressing injury caused by accident.
8. Injuries or damage from war, invasion, civil war, riots or acts of terrorism.
9. Injuries or damage caused by naval, military and air force operations.
10. Contamination by radio activity.
11. Participation in riots, strikes and civil commotion.
12. Injuries from riding or driving races and participation in extreme sports.
13. Stays at sanatoria, old age homes, places of rest etc..
14. Beauty treatment in nature cure clinics or health hydrotherapy.
15. Nervous breakdown, general debility, psychoneurosis, or senility.
16. Alternative treatment i.e., chiropractors, acupuncturists, herbalists and more.
17. Treatment not administered by a registered medical practitioner.
18. Any claim by or on behalf of any member whose application for insurance. contains any misstatement or withholds any material information.
19. Any expenses for which the member has been or can be reimbursed by any other Insurance or source, including benefits or compensation received under any Work Injury Benefits Act or Government Schemes (including NHIF), except for any excess of expenditure beyond the amount recovered from such other Insurance or source.