Medical Insurance


Medical Insurance is also called 'Health Insurance'; a type of insurance coverage that pays for medical and surgical expenses following illness or injury that are incurred by the insured member directly to care/medical providers.

Coverage designed to cater for families, small, medium sized and large organisations. Companies with as few as 3 staff can take up an SME or a Corporate cover

Cover is classified into the following two categories:

1. Inpatient:
A condition or procedure that requires the patient to be admitted to hospital overnight for a prescribed or indefinite period

2.  Outpatient:
A patient does not require admission and the treatment and/or procedure may be done at the doctor’s office/clinic

Additional riders:
Dental: Covers routine dentistry including dental consultation, prescription, extractions, fillings and dental x-rays

Optical: Covers routine optical consultations, prescription for frames and other optical prescriptions, prescribed lenses and replacement

Maternity: This benefits caters for in-patient expenses for child delivery and pregrancy relaated complications (including caesarean section and ectopic pregnancy).

NB: Inpatient is the primary benefit

Key determinants for a medical cover:

  • Determines premium 
  • New applicants over 50 years need to undergo a medical examination. Specific facilities are appointed to do these 
  • Minimum joining age 38 weeks; Upper age limit varies with the underwriter
  • Members can join as individuals/ family groups/ SME’s/ Corporates 
  • Family includes the principal, spouse and children under 18 years unless they are still dependents/ students
Plan Minimum limits Maximum limits
Inpatient   10 000 000
Outpatient 30 000 300 000
Dental 10 000 50 000
Optical 10 000 50 000
Maternity 30 000 300 000