Introduction: Your Health, Your Wealth

In Kenya today, a single hospital visit can drain months of savings. From emergency surgeries to chronic illness treatments, healthcare costs are on the rise—and the financial burden is heavy for those without a reliable health insurance plan.

At Bima Express Insurance Agency, we believe that every Kenyan deserves access to affordable, quality healthcare. That’s why we work with top insurance providers to help individuals, families, and businesses choose the best health cover for their needs and budget.

In this blog, we’ll guide you through the basics of health insurance in Kenya, the types of covers available, what to look for in a policy, and how to get started with Bima Express.

Why Health Insurance Is a Necessity in Kenya

1. Rising Medical Costs

Private hospital bills in Kenya can range from Ksh 5,000 for a basic consultation to over Ksh 1 million for surgeries or cancer treatment. Without insurance, these costs are often unmanageable.

2. NHIF Limitations

The National Hospital Insurance Fund (NHIF) provides basic inpatient coverage but is not always sufficient, especially for specialized treatment, private hospitals, or chronic illness management.

3. Health Emergencies Are Unpredictable

Accidents, unexpected illnesses, and health emergencies can happen at any time. Insurance ensures that you don’t have to choose between treatment and financial ruin.

4. Peace of Mind

With a good health plan, you can access medical services without delay—no worrying about hospital deposits or borrowing money during emergencies.

Types of Health Insurance Plans in Kenya

Kenyan health insurance providers offer a variety of plans tailored to different needs. At Bima Express, we help you understand and compare:

1. Individual Health Insurance

Best for single adults or retirees. Offers cover for:

• Inpatient hospitalization

• Outpatient services

• Specialist consultations

• Diagnostics (X-rays, labs, scans)

2. Family Health Insurance

Covers you, your spouse, and children under one plan. Ideal for families looking for:

• Maternity benefits

• Pediatric care

• Chronic illness cover

• Preventive screenings

3. Corporate/Group Health Insurance

Designed for businesses and organizations with 5+ employees. Benefits include:

• Group discounts

• Enhanced employee productivity

• Optional wellness programs

• Mental health support

4. Senior Citizen Health Plans

Customized for individuals aged 60+. These typically cover:

• Geriatric care

• Chronic illness management

• Emergency ambulance services

• Pre-existing conditions (in some plans)

5. Specialized Covers

Depending on your needs, you can get policies that cover:

• Dental and Optical

• Cancer Treatment

• HIV/AIDS Management

• Overseas Medical Treatment

What Does a Standard Health Insurance Policy Cover?

While every provider offers slightly different benefits, most health insurance plans include:

✅ Inpatient Cover

Covers hospitalization costs including:

• Room and board

• Doctor and specialist fees

• Surgery

• ICU and HDU care

• Nursing care

✅ Outpatient Cover

Includes:

• GP and specialist consultations

• Lab tests and diagnostic imaging

• Prescription drugs

• Minor procedures

✅ Maternity Cover

• Antenatal and postnatal visits

• Delivery (normal or cesarean)

• Newborn care

✅ Emergency Services

• Ambulance evacuation

• Emergency room visits

✅ Chronic Illness Management

• Diabetes, hypertension, cancer, etc.

• Long-term medication

• Specialist consultations

Key Things to Consider Before Choosing a Health Plan

1. Premium vs. Benefits

Cheaper isn’t always better. Look for value, not just the lowest price. Some affordable plans offer very limited cover and high co-payments.

2. Hospital Network

Ensure the insurer’s network includes your preferred hospitals, especially if you live in rural areas or prefer private facilities.

3. Waiting Periods

Some benefits—like maternity or chronic disease cover—have waiting periods of 6–12 months. Ask for this information before you sign.

4. Pre-existing Conditions

Disclose any existing illnesses upfront. Some plans exclude or charge higher premiums for such conditions.

5. Co-payments and Exclusions

Check how much of the bill the insurer will pay and what you must pay from your pocket. Also, understand what isn’t covered—e.g., cosmetic surgery or alternative medicine.

6. Family Size and Age

Your premiums will vary based on the number of dependents and their ages. Older dependents generally increase the cost.

Top Benefits of Using Bima Express to Buy Health Insurance

1. ✅ Access to Top Providers – We work with reliable insurers like AAR, Jubilee, Britam, APA, UAP Old Mutual, and more

2. ✅ Tailored Advice – We help match your budget and medical needs to the right plan

3. ✅ Transparent Pricing – No hidden fees or last-minute surprises

4. ✅ Support During Claims – We guide you through claim approvals, hospital pre-authorization, and follow-up

5. ✅ Free Consultations – Our expert team will walk you through plan comparisons—no pressure to buy

How Much Does Health Insurance Cost in Kenya?

Premiums vary depending on age, coverage level, and benefits, but here’s a rough guide: