Most health insurance policies in Kenya have a list of accredited hospitals and doctors. While you can visit others, you might have to pay higher out-of-pocket costs. Make sure you check which hospitals and clinics are covered when choosing your policy.

Choosing the right health insurance policy is crucial, as it affects both your financial well-being and health. Here are some considerations to keep in mind:

1. Coverage: Ensure the policy covers a comprehensive range of medical services, from outpatient consultations to major surgeries.
2. Network of Hospitals: Check if the policy covers the hospitals or clinics you prefer or are convenient for you.
3. Pre-existing Conditions: Understand how the policy treats pre-existing conditions. Some may have waiting periods or exclusions.
4. Premiums: Compare the cost of premiums against the benefits offered. The cheapest policy might not always provide the best value.
5. Claim Process: A seamless claim process is vital. Check reviews or ask for references to know about the insurer's claim settlement history.
6. Exclusions: Read the policy terms to understand what's not covered. This can include certain treatments, medications, or conditions.
7. Renewability: Opt for a policy that offers lifetime renewability, especially if you're buying at a younger age.
8. Waiting Periods: Some policies have waiting periods for specific treatments or conditions. Know these periods to avoid surprises.
9. Co-pay & Deductibles: Understand any out-of-pocket expenses you might incur when availing medical services.
10. Maternity and Childcare: If you're planning a family, check if the policy covers maternity and child health services.
11. Additional Benefits: Some policies offer added benefits like health check-ups, vaccinations, or wellness programs.

If you're unsure, consult with the mTek team to guide you through the options and nuances of health insurance policies available

‍

Pre-existing conditions are health issues that existed before the start of the policy. Some insurers might exclude them or cover them after a waiting period.

A cover limit refers to the maximum amount an insurance company will pay for claims within a specific period, usually a year. In health insurance, this can apply to the overall policy or specific treatments and services. For instance, if your policy has a limit of KES 500,000 annually, the insurer will only cover medical expenses up to that amount within that year. Any costs beyond the limit will be out-of-pocket for the insured. It's essential to understand your policy's cover limits to ensure adequate coverage and avoid unexpected expenses.

To apply for health insurance through our partner mTek, download the mTek app via the Google Play Store. Then:

• Once on the app, select insurance services -> Buy insurance -> and then Health Insurance.
• Proceed to follow the step-by-step instructions up to quote generation and proceed to select the cover of your choice.
• The premiums shown will be for inpatient or outpatient. Click the drop-down under each option for more details and also to purchase the premium.
• At the checkout and payment stage, choose between paying one time or in installments. For installments, the amount you need to pay as the first down payment – which is usually 20% of the total premium, will be indicated on the app as well as the subsequent monthly payment amounts.
• Proceed to input your mpesa number whereby you will receive a prompt to your mpesa to make payment.
• Once the waiting period elapses, your medical cover will be ready for use

‍

Add-ons are additional benefits that you can purchase along with your standard health insurance policy to enhance your coverage. Some common add-ons include critical illness cover, maternity cover, and dental and optical care. Additionally, in Kenya, some health insurance providers offer funeral cover as an add-on, ensuring that in the unfortunate event of a policyholder's demise, the burial expenses are catered for. It's essential to discuss with your insurance provider about the available add-ons to tailor your policy to your specific needs.