Health Insurance

7 Things to Consider Before Buying Medical Insurance in Kenya

7 important factors to consider before buying medical insurance in Kenya

Medical insurance is essential to ensure the health and well-being of your dependents and yourself. It helps to cater to medical expenses incurred due to illness, injury or accidents. While buying medical insurance is critical in securing your future, choosing health coverage remains a challenge for many Kenyans. And if you feel stuck in your research, here are the essential things to consider when buying medical insurance.


  1. Scope of Cover ↴
  2. Premium Amount ↴
  3. Network Hospitals ↴
  4. Policy Waiting Period ↴
  5. Co-Payment & Deductibles ↴
  6. Claims Settlement Record ↴
  7. Insurer’s Customer Support ↴
  8. Conclusion ↴

Scope of Cover

The coverage offered by the medical insurance policy is the most crucial factor to consider. Medical insurance plans come with various coverage options, such as hospitalization, diagnostic tests, medication, ambulance, etc. Ensure that the policy you choose provides comprehensive coverage that matches your needs. Be sure to check the terms and conditions of the plan to understand the extent of coverage and the exclusions.

Read Next: Health Insurance: Scope and Types of Cover

Premium Amount

The premium is the amount you pay periodically to keep the policy active. The premium amount varies from policy to policy and depends on different factors such as age, medical history, and coverage options. It is prudent to choose a health plan for which the premium amount fits your budget and does not strain your finances. Compare different medical insurance quotes before making a decision.

Network Hospitals

Network hospitals are a group of hospitals and medical centres that are affiliated with the insurance company. It is essential to check the list of network hospitals before buying the policy. Confirm that the policy allows you to access the hospitals you want, preferably those in your locality and that the network hospitals provide quality healthcare facilities.

Read Next: Britam Medical Insurance Cover -Milele: Learn More & Request Free Quote

Policy Waiting Period

The waiting period is the time between buying the policy and becoming eligible for coverage. Insurance companies use waiting periods to reduce fraud, and the applicable waiting duration varies from policy to policy and depends on the type of illness.

Get clarification of the waiting period before buying the policy, as it can affect the coverage of pre-existing medical conditions.

Co-payment and Deductibles

Co-payment and deductibles are the amounts that you have to pay out of your pocket before the insurance coverage kicks in. Often, co-payment applies to consultation fees. For example, if a consultation costs KES 2,500, you may need to pay KES 1,000, and the insurance company will cover the rest. Deductibles come in when the insurer is settling your medical bill and are quoted as a rate or a fixed amount.

Read Next: Madison Medical Insurance Cover – BetterLife: Learn More & Request Free Quote

Claim Settlement Ratio

The claim settlement ratio is the percentage of claims settled by the insurance company out of the total number of claims received. It is essential to choose an insurance company with a high claim settlement ratio, as it indicates the reliability and trustworthiness of the company.

Customer Support

The customer support your health insurance company provides is an essential factor to consider. Quick and efficient customer support, especially during emergencies. Check online for reviews and ratings of the insurance company to understand their customer support.

Read Next: The NHIF Medical Cover in Kenya: Everything You Need to Know

Wrapping it Up

In conclusion, buying medical insurance is a critical decision that requires careful consideration. Assess your needs, budget, and other factors before choosing a policy. Ensure that you understand the terms and conditions of the policy, and compare quotes from different insurance companies to get the best deal.

With the right medical insurance policy, you can secure your health and well-being and protect yourself from financial liabilities.

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