JAMII PLUS
Health insurance is not just for those that are sick, but it is also a great investment. This is why we have medical insurance products designed to cover individuals and families.
Our main products include: Inpatient cover which is the core cover. With this, one is covered for; Pre-existing, Chronic, Congenital, HIV/AIDS-related conditions, cancer treatment, organ transplant, lodger fees, accidental dental/reconstructive surgery among many more others.
With our range of health insurance products, we have made it easy for you to find the one that suits your needs. We have a wide variety of plans to choose from such as; Short Term Health Insurance, Long Term or Lifetime plans depending on your needs and budget.
WHAT JAMII PLUS CATERS FOR:
Covid-19 Covered
Covid-19 cover limit extended to match the limits offered limits offered under chronic / pre-existing conditions limit
Bed Charges
Including all accommodation expenses net of NHIF during your stay in the hospital. Whether in the Wards, HDU or ICU.
Medication
All prescribed drugs and dressings through our designated partners.
Doctor’s Fees
Any doctor related charges including those of physicians, surgeons, anesthetists, and specialists for visits and consultations.
Diagnostics
All prescribed laboratory tests, X-rays, Ultrasounds, MRI and CT Scans.
Our main products include:
Inpatient cover is the core cover.
With this, one is covered for; Pre-existing, Chronic, Congenital, HIV/AIDS-related conditions, cancer treatment, organ transplant, lodger fees, accidental dental/reconstructive surgery among many more others.Optional Benefits:
- Outpatient cover.
- Maternity cover.
- Dental & Optical Cover.
- Last expense cover
- Personal Accident Benefit Cover.
The cover also provides for enhanced benefits. This include:
- Cover for Pre-Existing, Chronic, Psychiatric, congenital and HIV/AIDS including related conditions.
- Countrywide Provider Network.
- Overseas inpatient referrals covered on credit under-listed hospitals.
- Cover for inpatient dental and optical treatment.
- Post hospitalisation benefit.
- Funeral expenses benefit.
- Free Personal Accident benefit for Principle member.
Who is eligible for the cover?
- Adults between the age of 18 years and 80 years.
- Children between the age of 1 month and 17 years
Maternity Cover
Children bring us happiness and blessings. As we prepared for our new bundle of joy, we should cater for the mother’s health and conditions pre birth. This is why we have a Maternity Cover that caters for:
- Normal delivery including professional fees, labour and recovery wards for all plans.
- Costs of delivery, and other related ailments and complications including ectopic pregnancies, miscarriage, etc.
- Cesarean section delivery including professional fees, labour and recovery wards.
Main Features include:
Inpatient cover is the core cover.
With this, one is covered for; Pre-existing, Chronic, Congenital, HIV/AIDSrelated conditions, cancer treatment, organ transplant, lodger fees, accidental dental/reconstructive surgery among many more others.
Optional Benefits:
- Outpatient cover.
- Maternity cover.
- Dental & Optical Cover.
- Last expense cover.
- Personal Accident Benefit Cover.
The cover also provides for enhanced benefits. This include:
- Cover for Pre-Existing, Chronic, Psychiatric, congenital and HIV/AIDS including related conditions.
- Countrywide Provider Network.
- Overseas inpatient referrals covered on credit under-listed hospitals.
- Cover for inpatient dental and optical treatment.
- Post hospitalisation benefit.
- Funeral expenses benefit.
- Free Personal Accident benefit for Principle member.
Who is eligible for the cover?
- Adults between the age of 18 years and 80 years.
- Children between the age of 1 month and 17 years.
Maternity Cover
Children bring us happiness and blessings. As we prepared for our new bundle of joy, it is best that we cater to the mother’s health and conditions pre-birth. This is why we have a Maternity Cover that caters for:
- Normal delivery including professional fees, labour and recovery wards for all plans.
- Costs of delivery, and other related ailments and complications including ectopic pregnancies, miscarriage, etc.
- Caesarean section delivery including professional fees, labour and recovery wards.
INPATIENT CORE PLANS
| OVERALL MAXIMUM BENEFIT PER YEAR | 10,000,000 | 5,000,000 | 2,000,000 | 1,000,000 | 500,000 |
|---|---|---|---|---|---|
| Bed limits net of NHIF | Private room up to Kshs 25,000 | Ensuite up to Kshs. 18,000 | SPR up to Kshs 12,500 | General Ward Bed | General Ward Bed |
| In-patient Benefits | – | – | – | – | – |
| Prescription drugs and dressings – discharge drugs allowed up to a maximum of 30 days supply | Covered | Covered | Covered | Covered | Covered |
| Physicians, Specialist & Surgical fees, including anesthetist fees subject to APA panel rates | Covered | Covered | Covered | Covered | Covered |
| Theatre charges, HDU & ICU | Covered | Covered | Covered | Covered | Covered |
| Diagnostic tests | Covered | Covered | Covered | Covered | Covered |
| Physiotherapy as part of treatment | Covered | Covered | Covered | Covered | Covered |
| Pre-existing / chronic conditions/HIV/AIDS/ Congenital conditions after 12 months of cover and on full disclosure at the time of joining | 1,000,000 | 500,000 | 400,000 | 300,000 | 200,000 |
| Organ transplantation (3rd year) excluding thecost of obtaining the donor organ. Covers operation costs for Kidney, Heart, Liver, Lung and Bone Marrow transplants | 500,000 | 500,000 | 300,000 | 200,000 | 100,000 |
| Psychiatry and psychotherapy conditions after 12 months of cover and on full disclosure at the time of joining | 500,000 | 250,000 | 200,000 | 150,000 | 100,000 |
| Post-hospitalisation Treatment- reimbursement only limited to the first 3 weeks after discharge | Covered | Covered | Covered | Covered | Covered |
| Accommodation costs for 1 parent staying in the hospital with insured child under 10 years | Covered | Covered | Covered | Covered | Covered |
| Day Care Surgery under General anesthesia | Covered | Covered | Covered | Covered | Covered |
| Nursing at home (on doctor’s recommendation) | 30 Days | 30 Days | 30 Days | 30 Days | 30 Days |
| Local ambulance to hospital for emergency cases | Covered | Covered | Covered | Covered | Covered |
| Treatment outside East Africa RESTRICTED TO INDIA where treatment is not locally available (Pre-authorisation required) On reimbursement basis. Airfare Costs for ethpatient only on a scheduled flight in Economy Class | Covered | Covered | Covered | Covered | Covered |
| CT, MRI, and PET scans subject to pre-authorisation | Covered | Covered | Covered | Covered | Covered |
| 1st ever emergency C-section &/or maternity-related complications after being on cover for 12 months. | 100,000 | 100,000 | 75,000 | 50,000 | 50,000 |
| In-Patient non-accidental Ophthalmology : includes cost of cataract-removal (1 year waiting period) | 100,000 | 75,000 | 75,000 | 50,000 | 50,000 |
| In-Patient non-accidental Dental (1 year waiting period) | 100,000 | 75,000 | 75,000 | 50,000 | 50,000 |
| Reconstructive surgery following an accident | Covered | Covered | Covered | Covered | Covered |
| Emergency dental / optical treatment following accident | Covered | Covered | Covered | Covered | Covered |
| Funeral expenses | Covered | Covered | Covered | Covered | Covered |
OUTPATIENT CORE PLANS
| ANNUAL LIMITS PER PERSON | 50,000 | 75,000 | 100,000 | 150,000 |
|---|---|---|---|---|
| Maximum Consultation Limit per visit | 2,000 | 2,500 | 3,000 | 3,000 |
| Physicians consultation fees | Covered | Covered | Covered | Covered |
| Prescription drugs up to a maximum of 30 days | Covered | Covered | Covered | Covered |
| Specialists fees (strictly on referral by a GP) | Covered up to 3,000 | Covered up to 3,000 | Covered up to 3,500 | Covered up to 4,000 |
| X-Ray, MRI’s, CT and other diagnostic tests | Covered | Covered | Covered | Covered |
| Physiotherapy prescribed by a GP | Covered | Covered | Covered | Covered |
| Treatment by chiropractors and osteopaths if on referral by a GP | Covered | Covered | Covered | Covered |
| Pre-existing/ Chronic conditions/ HIV AIDS/ Congenital Conditions after 12 months of cover & full disclosure at the time of joining | Covered | Covered | Covered | Covered |
| KEPI recommended vaccines covered for children up to 18 months | 7,500 | 7,500 | 7,500 | 7,500 |
| General Health Check-up for members from Age 21 and above | 5,000 | 7,500 | 10,000 | 10,000 |
If you are interested in learning how much this insurance product would cost you, or if you are interested in purchasing this insurance product, please click Get Cover.
If you would like further explanation or assistance about this insurance product, please click I Need Assistance.
Download forms will give you access to any relevant documents for this insurance product, such as the claim form, proposal form, etc.
