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