SME’s Economy Plan
| 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?
Downloading the application form, then fill it out, and present it to your nearest GA Insurance office, together with the required documents.
