JAMII PLUS

Living a healthy stress-free life is every person's dream. A healthy family is a happy family. This is why we have medical insurance products designed to cover individuals and families. 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.


WHAT JAMII PLUS CATERS FOR:

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:

  1. Outpatient cover.
  2. Maternity cover.
  3. Dental & Optical Cover.
  4. Last expense cover
  5. Personal Accident Benefit Cover.

The cover also provides for enhanced benefits. This include:

  1. Cover for Pre-Existing, Chronic, Psychiatric, congenital and HIV/AIDS including related conditions.
  2. Countrywide Provider Network.
  3. Overseas inpatient referrals covered on credit under-listed hospitals.
  4. Cover for inpatient dental and optical treatment.
  5. Post hospitalization benefit.
  6. Funeral expenses benefit.
  7. Free Personal Accident benefit for Principle member.

Who is eligible for the cover?

  1. Adults between the age of 18 years and 80 years.
  2. 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:
  1. Normal delivery including professional fees, labour and recovery wards for all plans.
  2. Costs of delivery, and other related ailments and complications including ectopic pregnancies, miscarriage, etc.
  3. Cesarean section delivery including professional fees, labor 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:

  1. Outpatient cover.
  2. Maternity cover.
  3. Dental & Optical Cover.
  4. Last expense cover.
  5. Personal Accident Benefit Cover.

The cover also provides for enhanced benefits. This include:

  1. Cover for Pre-Existing, Chronic, Psychiatric, congenital and HIV/AIDS including related conditions.
  2. Countrywide Provider Network.
  3. Overseas inpatient referrals covered on credit under-listed hospitals.
  4. Cover for inpatient dental and optical treatment.
  5. Post hospitalization benefit.
  6. Funeral expenses benefit.
  7. Free Personal Accident benefit for Principle member.

Who is eligible for the cover?

  1. Adults between the age of 18 years and 80 years.
  2. 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:
  1. Normal delivery including professional fees, labour and recovery wards for all plans.
  2. Costs of delivery, and other related ailments and complications including ectopic pregnancies, miscarriage, etc.
  3. Caesarean section delivery including professional fees, labor 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-Hospitalization 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.

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