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Why Health Insurance

This policy takes care of hospital bills for both in-patient and out-patient hospitalization. It also covers dental, optical and maternity bills and can be extended to cover emergency medical evacuation.

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Frequently Asked Question on CIC Seniors Mediplan

What options are there for payment in installments?

  • Premium is paid in full before cover commencement.
  • IPF is available – maximum of 4 instalments.

What is covered?

  • Inpatient
  • Outpatient
  • Dental & Optical
  • Last Expense
  • Covid – 19

Who can join?

  • Joining age is between the ages of 60 – 80 years
  • Principal Member and Spouse cover
  • After 80 years you can renew for life

What is the waiting period?

  • 30 days for outpatient and acute illness admissions.
  • 1 year for pre-existing and chronic conditions, gynaecological surgery, Psychiatric illness/ psychotherapy, Ophthalmologic surgery & Dental surgery treatment for both inpatient and outpatient.
  • 2 years for cancer and related treatments for both inpatient and outpatient.
  • 3 years for organ transplant.
  • 3 years for Reconstructive surgery.
  • There is no waiting period for accident cases.

What are the cover terms?

  • Co-payment schedule per Hospital for Outpatient services applies
  • List of service provider panel available (0ver 900 providers across Kenya)
  • All Covid test must be preauthorized and prescribed by a Doctor under the Outpatient benefit.
  • Membership is subject to Underwriting.

Can waiting periods be waived if I am transferring from another insurer?

The following documents will be required for review and advise on waiver of waiting periods – Waiting periods will be waived for members transiting within 30 days from another insurance underwriter or their

respective Corporate Medical Schemes subject to performance review and approval of waiver in writing;

  • The renewal invite from the other insurer with the terms
  • The claims utilization statement stamped by the previous insurer
  • Medical examination report (CIC will issue a medical examination letter upon review of the above)

Pre-requisite to joining– requirements for onboarding?

  • Dully completed and signed application form
  • Medical Examination Report – Upon receipt of the application form, CIC will issue you with medical examination letter. Cost of medical examination is borne by the member.
  • ID/Passport for both principal and spouse
  • KRA PIN for principal member

What are the limits covered?

Inpatient (300,000 – 5M) per family

Outpatient (50,000 – 200,000) per person

Dental (15,000 – 20,000) per person

Optical (15,000 – 20,000) per person

Last Expense (50,000 – 100,000) shared Principal and Spouse

Does the cover cater for flight incase of overseas treatment?

This is payable under economy class within the inpatient limit if the member has been referred by CIC.

What happens when someone gets to the maximum age while still on cover?

Existing members can continuously renew their membership without age restrictions.

What is the premium payable?

Age banded premiums based on the age of the older member between the principal and the spouse.

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