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What you need to know about an individual health insurance cover?

Good health is indeed one’s most precious asset to have and should be protected at all costs. 

While our national healthcare insurance systems are under a massive overhaul, the value of health insurance cannot be overstated.Being without health insurance can be a costly affair that may result in delayed treatment and thousands of shillings of medical expenses.

This could run one into bankruptcy, in the event of an accident, a deadly illness, or in the development of a chronic condition. 

That’s why it’s important to protect yourself by being an informed health insurance purchaser and buy what fits your needs. However, this is only possible if you are armed with proper health insurance knowledge.

This article specifically focuses on shedding light on individual health insurance and key shopping tips that will help you land just the right cover.

What is individual medical insurance?

Individual medical insurance is a health insurance cover meant to cover a single individual. In this case, the policyholder is the only insured person in the policy.

Is individual medical insurance for me?

Individual medical cover is ideal for a single unmarried person, or a child that is above 18 years who is no longer in school but still in their parents’ care. 

How much does it cost?

Mostly what you pay and how much cover you get from an insurer all depend on one’s specific medical needs. Cost of individual health insurance premiums will be influenced by the following factors:

  • Your age: The older you are, the higher your premiums are likely to get.
  • Your health: Certain aspects of your lifestyle, such as smoking or pre-existing cases, are also likely to raise your premium costs.
  • Your level of cover: The higher your level of cover, the more you will need to pay for the policy.

For example, For a 25 year-old, to get an in-patient of Kshs. 1,000,000 annually they may be required to pay a premium of only Ksh. 18,971 annually and for an out-patient cover of Kshs.50,000 annually a premium of Ks. 17,970. 

Once the policy is activated, the insurance company will pay 100% of the covered expenses minus the individual co-pays, NHIF rebate and declared sub-limits for each service or medical case.

To get the ideal cover limit, work with us at Bima Hakika to agree upon the limits and  help you purchase a policy seamlessly. 

Benefits of having an individual health cover;

Individual health insurance can be useful for several reasons:

  • You will easily complement NHIF cover limitations such as sub-limits. 
  • With individual medical health cover, you will have access to a greater range of treatments.
  • The cover allows you to choose which location or hospital you want to be treated at.
  • You have freedom to choose your own private room or a ward bed when admitted. With NHIF you may not be guaranteed a place in a private hospital or a private room in a government hospital.

However, if you do not think you will need these benefits, you may be better off not dealing with the extra cost and sticking with the NHIF.

What extra benefits can I get with individual health insurance?

Depending on the type of policy you take out, you might be able to add any of the following:

  • Dental care.
  • Eye care.
  • Physiotherapy.
  • Maternity and pregnancy care.

What does individual health insurance cover?

What your individual health insurance policy covers will depend on the level of insurance you purchase, however there are three major types;

  1. In-patient only (Mandatory): It is the main policy benefit  that covers you for treatment costs and any associated costs involved only when admitted to a hospital. 
  2. Out-patient: It is an optional benefit added to the main in-patient policy that covers costs associated with walk-in medical expenses, the outpatient services may include blood tests, scans, and specialist consultations etc.
  3. Comprehensive In-patient & out-patient: A comprehensive individual health insurance policy that includes all the above, while also covering you for physiotherapy and general wellness checkup, maternity, dental and optical care.

How can I compare my individual health insurance costs?

If you want to purchase a health insurance policy, comparing your options with us at Bima Hakika with our tried and tested top health insurers is the best way to find a perfect deal. 

All you need to do is engage our happy relationship managers, tell us a little about yourself, your health, and your lifestyle, and we will show you an indicative price for both basic and comprehensive health insurance cover.

Our Wiz

Before you can buy a policy, you must pay attention to the policy language and terms, we help you do this to ensure that the desired coverage is adequate to meet your potential needs.

Remember when choosing a deal, the cheapest quote is not always the best. 

It is best to aim for a balance between a reasonable price and the right amount of cover depending on your specific needs, this way you can avoid ending up over-insured or under-insured.

Lets Engage Today

This article is written by our Principal Officer Winnie M., who has vast insurance knowledge spanning over 10+ years in the industry. You can write to her and/or share feedback via this email bimahakika@gmail.com


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