Surgicare

Surgicare

Surgicare - Pop up3

Surgicare plan is an insurance product that shoulders the financial burden of surgical expenses related to heart, cancer, vascular, orthopedic among others.  

 

Contact Us

To Schedule Emergency Admission, Call Numbers:

Helpline: 0737 711 633 | 0710 607 333 | 020 2711633

MOMBASA: 0736 372 881 | KISUMU : 0733 154 415

Email us: careteam@gakenya.com | Health@gakenya.com

CONTACT PERSONS

Nairobi : Mburu / Paul Mombasa : Chris Kisumu: George

GA Insurance House,

4th floor, Ralph Bunche Road,

P.O. Box 42166 00100, NBI, Kenya.

SURGERIES COVERED
Open heart surgery; including congenital and paediatric
Thoracic surgery
Surgical oncology - Cancer operations
Neurosurgery
Vascular surgery
Orthopaedic/Joint Replacement
COVER DETAILS
Annual limit of $200,000
Cover includes pre-existing conditions subject to stated waiting periods.
One free check-up on return by Surgicare doctors
Includes meet and greet by Narayana team
Age limit: 1 Day to 65yrsy
Consumables during hospital stay
Professional fees - Surgeons and anaesthetists
Visiting consultations
Nursing and bed charges - General Ward Bed.
ICU and HDU regardless of complications.
ANNUAL PREMIUM
AGE PREMIUM (per year) (Including taxes) WAITING PERIOD
1 day - 45 Years $450 6 Months
46 Years to 65 years $600 6 Months
Minimum population 5 Members *Premium is per person payable in dollars.
CLAIMS PROCESS
Process Details and Requirements Responsibility (TAT)
Eligibility Confirmation of member’s eligibility and Nature of treatment (pre-existing, congenital, elective or emergency). Within the hour of receiving the Preauthorization request.
Confirmation of Condition Assessment of condition and review of submitted information of the condition. This includes visiting the selected MDT. Within 48 hours
Visa and GOP A (Guarantee of Payment) GOP is issued. A letter of invitation is provided for visa and other documentation processing. Within 12 hours
Insured Travel for Treatment The insured will travel to the location of the treatment within 21 days of the GOP.. Within 21 days
Insured ReturnP Upon return the beneficiary will have a post-operative visit to complete the treatment cycle. Within 7 days

OPTION A : STAND ALONE PLAN



Main exclusions
  • Cost of any medical implant or device
  • Cost of pre-operative and post-operative medical expenses for inpatient and outpatientl
  • Post-operative outpatient expenses related to surgery complications unless it occurred within 30days after surgery only
  • Transfer/evacuation charges.
  • Interventional cardiology procedures.
  • For the purposes of the Surgicare range of products, invasive cardiology or interventional cardiology procedures performed by a cardiologist are not included. Examples include but not limited to:


  • Coronary Angiography (or, Arteriography),
  • Diagnostic Left and Right Heart Cardiac Catheterisation
  • Swan Ganz Catheterization (Hemodynamic Monitoring with Balloon Flotation Devices),
  • 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
  • Pericardiocentesis,
  • Pacemaker or CRT device insertion,
  • Insertion of IABP Balloon Valvuloplasty, and,
  • Coronary Stent.

OPTION B: TOP-UP SUPPLEMENTARY PLAN

The exclusions under options A are included and payable under underlying cover subject to terms and conditions.



SURGICARE APPROVED PROVIDER: NARAYANA GROUP OF HOSPITALS (NH)

  • Narayana Health (NH) Group of hospitals owns and operates more than 7,000 beds in 37 hospitals with multi specialty units in all surgical and specialization areas in the field of medicine.
  • Narayana Health (NH) has facilities in Regions of Mumbai, Ahmedabad, Delhi, Bangalore, Shivamogga, Kolkata, Jaipur and other main cities of India. Surgical Team will recommend the facility to which best care and specialty is available for the potential patient upon review.
  • Surgical Team will review the referral and agree to see the potential patients 30 days to acceptance of a case.
  • Surgical Team will reserve spaces in its schedule for cases of urgent care.

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.