Dispensaries are government hospitals closest to the citizens. They offer simple outpatient services. Conditions which require more intensive observation, patients are often referred to more advanced hospitals in terms of services and specialists.
The health centers are hospitals that not only offer simple services like common cold but also offer the prevention services. These hospitals also operate as a referral hospitals from the dispensaries.
Nursing hospitals are hospital run by churches, organizations or individuals. They offer medical services that require more care and also the operational services.
Private hospitals are hospitals that are more organized with more specialized personnel and advanced equipment. They offer all services including the consultation, diagnostics and many more, most patients who visit these are covered with a medical insurance in Kenya.
We have another category of hospitals that is the sub county hospitals and county hospitals which act as the main referral centers for the small hospitals. The services here are more specialized and patients can get more comprehensive treatment while the county hospitals have extra services and resources i.e capacity to care intensive care services, they have life support machines and can carry more complex tests.
National hospitals provide all the health services which may not be available in these other hospitals.
This is the cost one is supposed to cater for anytime he or she visits specific hospitals and the reason is to discourage people to visit hospitals for unnecessary attentions.
Co-payment varies from on hospital to another and also depends on the health cover provider.
Overseas treatment? On re-imbursement? Ticket included or not
Overseas treatment is normally covered up to a certain limit normally it is on referral basis. The most common is South Africa and India. Most affordable Kenyan medical covers allow overseas treatment on referral. For many conditions, it may be cheaper and safer to have them treated overseas as the cost of medical treatment and hospitalization continues to increase here in Kenya. This is normally done on re-imbursement basis.
NHIF has empowered more citizens to access medical care. NHIF covers various services i.e.
- Bed entitlement.
- Artificial appliances like braces, thoracic collars and other orthopedic appliances.
- Eye and dental treatment.
- It also covers surgical services.
- Various tests including CT-Scan and MRI.
- Costs of medicine, registration and consultation are also covered by the NHIF.
When a policy holder is an NHIF member, he or she has added advantage because it can be used when seeking attention of the above services. Also health cover pays bed entitlement net of NHIF rebates.
Who are eligible?
Children are covered to a maximum of 21 years, any children above 21 years to a maximum of 25 years can be covered as long as they show proof of being in fulltime education on a health insurance in Kenya.. The student ID should give information about when one will complete his or her studies.
Last joining age vary from one provider to another. Members above 55 years are supposed to provide medical examination report before being given acceptance letter.
Most covers have last expense limit as from 50,000 to 250,000. This is payable on death of any declared family member but has a maximum of 2 claims per a year.
Insurance companies have 24 hour emergency lines.
International medical covers? What are they and what’s the difference
These are health covers created and controlled to offer international healthcare solutions for individuals who constantly move across the world i.e, employees of international organizations, multinationals, and small & medium enterprises. These international health insurance packages are much more expensive that ordinary Kenyan health insurance covers owing to the executive level services they offer.
Some of the main providers in Kenya include AXA PPP, BUPA, AETNA, NowHealth, Allianz and many others.
The main difference between the local covers and international covers is that the international covers’ scope of cover is internationally that means one can get services anywhere in the world without limited to which hospitals and panel of providers to visit.
International health covers are often seek by individuals who work, live and do business outside their country of origin but time and again travel back to their mother country to either visit family, friends and even business. As well family members may visit. In this regard an individual may want to cover his or her family comprehensively against any risk while they are on the foreign land.
Services in international and local covers can be the same.