How Medical Insurance works


Medical insurance in Kenya can be arranged individually, but the bulk of medical insurance is often arranged on a group basis by an employer as an employment benefit to its employees, or for members of a club, Chama or other affinity group.

Medical insurance for individuals, can also be extended to include a spouse and eligible dependents (children usually up to the age of 18 or 21 years if they are still students in kenya) under the same policy.

Medical insurance usually provides a range of benefits, including the costs of:

  • Hospital charges, including accommodation, theatre fees and the cost of surgical dressings and drugs
  • Specialist’s fees for both consultations and treatment, including surgeons’ and anaesthetists’ fees
  • Dental and optical treatment fees
  • Complementary therapies
  • Other costs, such as ambulance fees and home nursing fees

Note that not all of these benefits are provided by every policy. Medical insurance in Kenya is provided in two forms namely;

  • Outpatient
  • Inpatient

Most insurers and most medical in the market usually have a limit to the amount payable in any one year.


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