Inpatient/ Outpatient

SME Premier plan

sme-premier-plan

Inpatient/ Outpatient

Inpatient Rates
Limit Bed Type M M+1 M+2 M+3
10,000,000 KES 18,000 KES 43,953 KES 59,337 KES 77,138 KES 96,422
5,000,000 KES 16,500 KES 39,665 KES 53,548 KES 69,612 KES 87,015
4,000,000 KES 12,500 KES 36,180 KES 48,843 KES 63,496 KES 79,370
3,000,000 KES 12,500 KES 32,946 KES 44,477 KES 57,820 KES 72,275
2,000,000 KES 12,500 KES 32,036 KES 43,249 KES 56,223 KES 70,279
1,000,000 KES 12,500 KES 31,126 KES 42,020 KES 54,626 KES 68,283
750,000 KES 10,000 KES 27,226 KES 36,755 KES 47,782 KES 59,727
500,000 KES 10,000 KES 22,936 KES 30,964 KES 40,253 KES 50,316
250,000 KES 10,000 KES 18,196 KES 24,565 KES 31,934 KES 39,917
Note: Families above 4 members
pay individual rates
Outpatient Rates
Limit Consultation M M+1 M+2 M+3
250,000 KES 3,000 KES 58,215 KES 78,590 KES 102,167 KES 127,709
200,000 KES 2,500 KES 45,612 KES 61,576 KES 80,049 KES 100,061
150,000 KES 2,500 KES 35,739 KES 48,248 KES 62,722 KES 78,402
100,000 KES 2,000 KES 28,003 KES 37,804 KES 49,145 KES 61,432
Note: Families above 4 members
pay individual rates
Optical and Dental
Limit 10,000 20,000 30,000
Optical premium per person KES 3,750 KES 7,800 KES 10,500
Dental premium per person KES 4,550 KES 8,250 KES 11,250
Maternity
Limit 50,000 75,000 100,000
Premium per family KES 10,500 KES 15,000 KES 18,750
Annual cover limits
Eligible age 38 weeks t0 70 years (last joining age is 60 years)
Inpatient hospitalization services Covered
Day case procedures Covered
Physiotherapy Covered
Pathology, x-ray, ultrasound, ECG and computerised tomography, MRI Covered
Radiotherapy and chemotherapy Covered
Overseas eacuation for treatment not available locally Covered
HIV/chronic/pre-existing condition declared and accepted by GA Insurance Ltd. KES 300,000 or 50% of overall benefit whichever is lower
Congenital conditions declared & accepted by GA Insurance Ltd. KES 100,000
Emergency evacuation & ambulance services Covered
Inpatient ophthalmology KES 50,000
Inpatient Dental KES 50,000
Inpatient psychiatry/psychotherapry KES 200,000
Rehabilitation/post-hospitalization 25 days after discharge upto KES 30,000
1st emergency operation for caesarean section in ones life KES 100,000
Cataract operation KES 60,000
Last expense cover KES 50,000
KEPI Immunization Covered
Lodging facilities for parent accompanying a child 10 years
Counselling Upto 10 sessions
Main exclusions
  • General health check-ups
  • War and kindred risks (whether war be declared or not)
  • Cosmetic surgery, unless necessitated by an accident
  • Family planning/infertility
  • Treatment other than by registered medical practitioner
  • Intentional self-injury, drunkenness, drug addiction
  • Naval, military or air force operation
  • Expenses recoverable under any other insurance, e.g. GPA, NHIF, WIBA
  • Beauty treatment in nature cure clinics or health hydros
  • Contamination by radio activity from nuclear fuel, waste or fisision
  • Age related hearing aids and senility

Ready to start?

Download form

Downloading the application form, then fill it out, and present it to your nearest GA Insurance office, together with the required documents.