Inpatient and Outpatient

SME’s Economy Plan

smes-economy-plan

Inpatient and Outpatient

Inpatient Rates
Limit Bed Type M M+1 M+2 M+3
5,000,000 KES 12,500 KES 35,698 KES 48,192 KES 62,650 KES 78,312
4,000,000 KES 12,500 KES 33,596 KES 45,355 KES 58,961 KES 73,701
3,000,000 KES 12,500 KES 30,412 KES 41,056 KES 53,373 KES 66,716
2,000,000 KES 12,500 KES 29,572 KES 39,922 KES 51,899 KES 64,874
1,000,000 KES 12,500 KES 28,732 KES 38,788 KES 50,425 KES 63,031
750,000 KES 10,000 KES 25,132 KES 33,928 KES 44,107 KES 55,133
500,000 KES 10,000 KES 21,172 KES 28,582 KES 37,157 KES 46,446
250,000 KES 10,000 KES 16,796 KES 22,675 KES 29,477 KES 36,846
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 51,746 KES 69,857 KES 90,814 KES 113,518
200,000 KES 2,500 KES 40,544 KES 54,734 KES 71,155 KES 88,943
150,000 KES 2,500 KES 31,768 KES 42,887 KES 55,753 KES 69,691
100,000 KES 2,500 KES 24,892 KES 33,604 KES 43,685 KES 54,607
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 55 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 30 days after discharge upto KES 30,000
Inpatient Dental KES 50,000
Inpatient psychiatry/psychotherapry KES 200,000
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.