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7/27/2019 AfyaImara View

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Kenya

HEAD OFFICEUAP Insurance Company Ltd

Bishops Garden Towers, Bishops Road

PO Box 43013, Nairobi, KENYA

Tel +254 - 020 - 2850000

Fax +254 - 020 - 2719030

Customer Care Centre - Queenswa House

Tel: 2228070, Wireless: 3572 845

E-mail: [email protected]

Website: www.uapkenya.com

Nakuru:Tel 051 - 2212910


Mombasa: Tel 041 - 2223777/8


Nyeri:Tel 061- 2030660


Eldoret:Tel 053 - 2061437/8


Kisumu:Tel 057 - 2020119

E-mail: [email protected]:Tel 044 - 20011, Fax 044 - 21425

Meru:Tel 0722 996728, Wireless 020-2423190

UgandaHEAD OFFICE

UAP Insurance Uganda Ltd

UAP Insurance Building

PO Box 7185, Kampala - UGANDATel +256 - 41 - 4332 700,

Fax +256 - 41 - 4256388


website: www.uapinsurance.co.ug

Southern SudanHEAD OFFICE

UAP Insurance Sudan Limited

Juba Oce

Plot No.3 Block VI at Hai Suk Juba TownPO Box 201 Juba - SOUTH SUDAN

Tel + 249811823811, 249811823814,

Satellite +8821643331581,

Mobile +256 477103923, +256 477104067

Email: [email protected]

AaImara

INPATIENT/OUTPATIENT HEALTH INSURANCE

MARCH 2011


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Wh Aaimara? NoExcessforinpatientcover

CoverforPre-ExistingConditions

CoverforChronicConditions&HIV/AIDS

InstallmentPremiumPaymentsfor

inpatientcoverandfullpaymentIfa

claim Is reported

CountrywideProviderNetwork

NoAccommodationBusinessRequired

WideGeographicalCoverage:

(Treatment in Kenya, Uganda, South

Sudan and India)

Overseastreatmentoncreditunder

listed hospitals RoadEvacuation

AirEvacuationbyAMREFforcover

limitsof1millionandabove.

FlexiblePackageapplicableto

Individuals,Families,Groups;SMEs,

etc

VolumeDiscountapplicableto

packagewithover10Persons

Countrywide&RegionalUAPOces

:AllMajorTownsinKenya;

Uganda&SouthernSudan

Noclaimdiscount(NCD)

Overseasemergencytreatmentfor

coverlimitaboveKShs3millionfor

therst42daysofTravel


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BENEFITS SCHEDULE in Kshs.

All benefts are subect to the overall cover limits

per annum.

General benefts in patient

Hospitalizationexpensesincludingsurgeon,physician,theatre,ICU

&HDUfees

Diagnosticsandphysiotherapistsfees,prescribeddrugs,dressings,

surgical appliances Accommodationcostsforparent/guardianaccompanyingchildof

6 years and below

Main benefts inpatient

Inpatient Overall Cover 500,000 1,000,000 3,000,000 5,000,000

Bed limits (net o NHIF rebate) General Ward General WardStandard

PrivateEnsuite

Funeral expenses per member (as a separate limit) 50,000 50,000 50,000 50,000Pre-existing chronic conditions on ull disclosure at the time o

joining ater (one year waiting period)150,000 250,000 300,000 300,000

Newly diagnosed chronic conditions (ater one year o claiming

to the ull limit.)150,000 250,000 500,000 1,000,000

Post-hospitalizationtreatmentrelatedtoreasonadmission

(reimbursement only, limited to the frst 3 weeks ater

discharge.)

15,000 20,000 20,000 30,000

In patient non-accident related eye treatments excludingsurgeryforrefractiveerrorsandlasertreatment(oneyear

waiting period)

75,000 75,000 100,000 100,000

In patient non-accident related dental surgery/treatment (ater

sixmonthsofcoverandsubjecttoapprovalbeforeadmission)20,000 30,000 40,000 50,000

Gynecological surgery (one year waiting period) 200,000 300,000 350,000 350,000

Organtransplantaftertwoyearsofcover(costofdonoror

securing the organ is excluded)250,000 300,000 500,000 500,000

Internal and external surgical implants, appliances, joint

replacements and prostheses (excluding dental fxtures)300,000 300,000 400,000 600,000

Psychiatry and psychotherapy 150,000 250,000 300,000 300,000

Cancertreatmentafteroneyearofcover. 250,000 350,000 500,000 500,000

Illnessrelatedreconstructive/plasticsurgeryfromthethirdyear

ofcover(excludescosmetic,obstetricandgynecologyrelated)150,000 150,000 150,000 150,000

Non accident related maxilloacial surgery. (Excluding routine

dental surgery and dental fxtures)

150,000 200,000 300,000 300,000

Congenital deects and genetic disorders ater one year o

cover.150,000 200,000 250,000 250,000

HIV/AIDSandrelatedconditionsafteroneyearofcover. 200,000 200,000 300,000 500,000

OptionalMaternityafteroneyearofcover


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How do I sign up or the cover?

Please contact UAP Insurance or your insurance

intermediary and fll the application orm. Ensure you

complete the application orm in ull and as accurately

aspossibletofacilitatequickprocessingofyourcover.Submit the duly flled orm and the premium cheque to

UAP Insurance. All members as proposed will be issued

with an Ayaimara membership card and a policy

documentwillbeissuedforeveryproposal.

General Conditions

WaitingPeriods o 28 days or illness claims and60 days or non-accident surgical claims.

Personsover60yearswillberequiredtosubmit

a medical report in the prescribed manner or

eligibility.

AmemberhastopresenttheirUAPmedical

cardsatthehealthserviceprovider.Informthe

attendingproviderthattheyarecoveredby

UAP.

Eligibilityisallpersonsandtheirlegal

dependantsfromageofzero(0)monthstothe

ageofsixtyve(65)years.Existingmembers

can continue renewing in the scheme up to age

seventy(70)years.

Eligibledependantsincludeonespouse,own

children rom age o 0 months to 18 years o

age.Childrenabove19yearswillbecoveredas

principal persons.

Outpatient:

Co-paypayableattheproviderKshs300per

visit.

Catersforroutineoutpatientcareand

treatment. Pre-existingandchronicconditionshavea

waiting period o 1 year and subject to a sub-

AnnualCover

limits

500,000 1,000,000 3,000,000 5,000,000

19 yrs - 29 yrs

Principal Member 15,980 17,970 28,330 32,330

Spouse 13,380 14,960 23,940 27,250

Child (0 months to

18 yrs) 7,430 9,530 16,210 18,150

30 yrs - 40 yrs

Principal Member 16,810 18,920 29,870 34,110

Spouse 14,050 15,730 25,220 28,720

Child (0 months to

18 yrs) 7,430 9,530 16,210 18,15041 yrs - 50 yrs

Principal

Member 17,730 19,930 34,930 36,270

Spouse 14,710 16,460 29,170 30,270

Child (0 months

to 18 yrs) 7,430 9,530 16,210 18,150

51 yrs - 65 yrs

PrincipalMember 21,980 25,130 37,880 43,220

Spouse 17,960 20,660 31,620 35,960

Child (0 months

to 18 yrs)7,430 9,530 16,210 18,150

Out Patient cover option(annualcoverlimitperperson)Option Limit Premium per lie

1 150,000 26,000

2 100,000 23,640

3 60,000 20,190

Premium table - Inpatient (annualcoverlimitperfamily)

Maternity cover option (annualcoverlimitperfamily)

Option Limit Premium per family

1 100,000 22,500

2 75,000 15,000

3 40,000 9,500


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limit o 30,000.

Excludesroutinemedicalcheckups.

Strictlyprovidersonourstandardpanel;no

reimbursementsforprovidersoutsidethe

standard panel.

Excludesdentalandopticalbenets.

Privatevaccinesexcluded.

Standardcoverexclusionsapply.

Outpatientcancertreatment.(Radiotherapy

andChemotherapy)afteroneyearofcover.

Exclusions Illnessclaimsincurredwithintherst28daysof

cover.

Surgicalclaimsincurredwithintherst60days

ofcover.

Amountsrecoverablefromotherinsurances

such as NHIF, GPA

Expenseswherematerialinformationis

withheld or misstated. Benetsnotspeciedinthebrochureand

policy.

Treatmentbyanyotherthanacertiedmedical

practitioner.

Expensesincurredinconnectionwithactive

participationinriots,civilunrestetc

Selfinictedinjuryandattemptedsuicide

Homeopathy,chiropractictreatment,

acupuncture, herbal medicine and treatment

Medicalcostsduetoexperimentaltreatment.

Professionalandhazardoussportsactivities.

CosmeticSurgery

Infertility

HospitalizationBillsincurredbyamemberata

nonappointedprovider. Alcoholism&conditionsrelatedtoalcohol

intoxication

SERVICE PROVIDERS - INPATIENT

A. Cover limits: 3,000,000 and 5,000,000

NAIROBI TheAgaKhanHospital

MaterMisericordaeHospital GertrudesGardenChildrens

Hospital

NairobiHospital

KarenHospital

NairobiEquatorHospital

MetropolitanHospital

SinaiHospital

JamaaHospital

St.FrancisCommunityHospital

Kasarani

MelchizedekHospital

M.P.ShahHospital

NairobiWestHospitalLtd

CopticNursingHome

NairobiWomensHospital

MenelikHospital

ChiromoLaneMedicalCentre

LionsSightrsteyehospital

KISUMU TheAgaKhanHospital

St.LukesMedicalServices

ThePortFlorenceCommunity

Hospital

AcaciaMedicalCentre.

BUSIA TanakaNursingHome

BUNGOMA ElgonviewCottageHospital

ELDORET MoiTeaching&ReferralHospital

ElgonViewHospital

MedihealHospital

UasinGishuMemorial


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KITALE Mt.ElgonHospital

CheranganyNursingHome

KISII HemaHospital

AgakhanKisii NyangenaHospital

WEBUyE LuguluMissionHospital

KERICHO SiloamHospital

MIGORI StJosephsHospital

HOMABAy StJude-ICIPE

SIAyA BamaNursingHome

LWAK StElizabethLwak

AluorhealthCentre.

KAKAMEGA St.ElizabethHospitalMukumu

CentralNursingHome

FriendsHospital-Kaimosi

MUMIAS St.MarysMumiasHospital

KENDU BAy KenduMissionHospital

LUANDA EquatorMedicalServices-

Luanda

MOMBASA TheAgaKhan,Hospital

PandyaHospital

MombasaHospital

MainlandHealthC

BomuMedicalC

TudorN.Home

JochamHospital

NyaliChidrensHospital

VOI VoiMedicalCentre

KILIFI PwaniMedicalCentre

DIANI PalmBeachHospital

UkundaMedicalCentre

MALINDI TawqHospital

StarHospital

LAMU LangoniHospital

NANyUKI NanyukiCottageHospital

NAKURU ValleyHospital

NakuruWarMemorialHosp

THIKA CentralMemorialHospital

NaiduHospital

MeridianMedicalCentre

SherHospital

NAIVASHA Mt.LongonotMedicalServices

MURANGA MarieStopes(MurangaNursing

Home)

NyAHURURU NyahururuPrivateHospital

NyERI OutspanHospital

ConsolataHospital

KarenOutreachClinic


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KARATINA JamiiHospital

KIAMBU GoodSamaritanMedical

Centre

AgaKhanHospitalGITHUNGURI BetaHealthcare

KIjABE AICKijabeHospital

MACHAKOS ShalomHospital-Dr.

Onyango

BishopUrbanusKiokohospital

MWINGI MwingiBarakaNursingHome

ATHI RIVER AthiRiverN.Home

KITENGELA AgaKhanHospital


KIBWEzI TumainiHospital

MERU MilimaniMaternity&Nursing

Home

MERU WoodlandsHospital

Dr. Wangai

ConsolataHospital

MAUA PreciuosLifeHealthcare

CHOGORIA PCEAChogoriaHospital

CHUKA StLuciesHospital

KITUI JordanHospital

KAKUMA KakumaMissionHospital

EMBU JoykimNursingHome

KERUGOyA ACKMtKenyaHospital

NAROK MaasaiNursingHome

GARISSA IslamicReliefMedicalservices

MedinaDiagnostics

DADAAB MedinaDiagnostics

LOKICHOGGIO AICHealthMinistries

MANDERA BlueLightNursingHome

ElwakNursingHome

MARSABIT TumainiMedicalCentre

MarsabitModernMedical

Services


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B. Cover Limits; 500,000 and 1,000,000

Aspertheserviceproviderlistin(A)excludingthe

ollowing Hospitals.

NairobiHospital

KarenHospital MaterHospital

MPShahHospital

C. Regional and Overseas List

UGANDA InternationalHospitalKampala

St.RaphaelHospitalNsambya

RubagaHospital

KololoHospital

MulagoHospitalPrivatewing.

NakaseroHospital

MengoHospital

CaseHospital

SUDAN InternationalHospitalJuba

St.LukeInternationalMedical

Centre

DaGenesisHealthServices

VictoriousMedicalCentre

MunukiMaternity

YeiMedicalCentre

Sunset

INDIA 7 major hospitals

SERVICE PROVIDERS - OUTPATIENT

NAIROBI TheAgaKhanHospital


GertrudesGardenChildrens Hospital

MetropolitanHospital

EquatorHospital

MOMBASA TheAgaKhan,Hospital

MainlandHealthC

BomuMedicalC

TudorN.Home

JochamHospital

NyaliChidrensHospital

Outside Nairobi and Mombasa

(referinpatientproviderlist)

Theproviderlistisreviewedregularlyandwillbe

posted to our website.

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