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Jubilee Health Insurance Medical Cover – Cost, Overseas Treatment, Hospital and Reviews

Jubilee Health Insurance Medical Cover – Cost, Overseas Treatment, Hospital and Reviews

Name: Jubilee Health Insurance Medical Cover – Cost, Overseas Treatment, Hospital and Reviews
Price range: 700

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Jubilee Health Insurance Medical Cover

One of the forerunners in the formation, the Jubilee Insurance Company of Kenya was founded on August 3, 1937, in a modest office in Mombasa.

Jubilee Insurance took the risky step of becoming a public corporation, in keeping with its goal of assisting in the region’s economic progress. To increase its local ownership base, which presently has more than 5,000 stockholders, in 1984. Today marks the Jubilee of more than 75 years since its founding.

A significant insurance provider in East Africa, Jubilee Insurance places a strong emphasis on policyholder protection and information. It has the greatest shareholder money. Technology, devoted, experienced, and professional employees, as well as a track record of providing excellent customer service.

Jubilee J Care Medical Insurance

With J-Care medical insurance, our clients have the freedom to select the facility and kind of care that best suits them. Adults between the ages of 18 and 60, as well as children between the ages of 1 month and 17 years, are eligible members for this coverage.

N/B: Before membership and eligibility for coverage may be confirmed, members over 50 must have a medical exam at a designated medical facility. Please be aware that this will be at the expense of the applicant.

Jubilee Medical Insurance Benefits

1. Five levels of complete coverage with add-on advantages (maternity, outpatient, dental and optical). Pick the strategy and features that best meet your needs and financial constraints for medical insurance.
2. Protection against pre-existing, persistent, mental health, congenital, and HIV/AIDS conditions, as well as their linked conditions.
3. Nationwide network of providers
4. Credit-covered overseas inpatient referrals from hospitals on the list
5. Pay for inpatient dental and vision care

6. Benefit following hospitalization

7. Benefit of funeral expenditures
8. Direct access to care while travelling throughout East Africa

9. Free Personal Accident Benefit for Principle Member

Jubilee Insurance Cost and Plans

J-CARE
INDIVIDUAL/FAMILY MEDICAL INSURANCE
INPATIENT BENEFITS (CORE PRODUCT – COMPULSORY)
All inpatient treatment is subject to pre authorisation
All benefits are subject to overall annual benefit unless specified otherwise. Amounts shown in in Kenya Shillings
	CLASSIC	PREMIER	ADVANCED	EXECUTIVE	ROYAL
Overall benefit limits in KES per insured family per annum	500,000	1,000,000	2,000,000	3,000,000	5,000,000
Pre -existing and/or chronic conditions, gynaecological conditions, Hernias, Haemorrhoids, Thyroidectomy, Adenoidectomy, congenital, organ transplant, HIV/AIDS and related conditions existing/not existing and/or not diagnosed at the time of joining. (1 year waiting period)	250,000	300,000	400,000	500,000	1,000,000
Cancer treatment subject to above conditions (2 years waiting period)	250,000	300,000	400,000	500,000	1,000,000
Psychiatric conditions subject to above conditions (1 year waiting period)	100,000	200,000	250,000	300,000	500,000
Pre maturity – for child born to an existing member who has completed 1 year waiting period on maternity benefit	50,000	100,000	150,000	200,000	250,000
Bed Limits per day. NHIF rebate will be applied on the limits shown	General Ward Bed	General Ward Bed	General Ward Bed	Standard Private Room up to KShs. 12,500	Standard Private Room up to KShs. 18,000

Lodger fees for parent accompanying sick child member	Covered for child under 10 years	Covered for child under 10 years	Covered for child under 10 years	Covered for child under 10 years	Covered for child under 10 years
Physicians, specialists, surgical fees including anaesthetist fees, theatre charges, HDU, CCU & ICU, diagnostic tests, physiotherapy as part of inpatient treatment	Covered	Covered	Covered	Covered	Covered
Inpatient MRI/CT Scans and PET Scans (subject to pre authorisation)	Covered	Covered	Covered	Covered	Covered
Surgical appliances/internal prosthesis	Covered	Covered	Covered	Covered	Covered
Reconstructive surgery following an accident	Covered	Covered	Covered	Covered	Covered
Inpatient non accidental related dental surgery/ treatment (1 year waiting period)	100,000	100,000	100,000	100,000	100,000
Inpatient dental surgery from an accident	Covered	Covered	Covered	Covered	Covered
Inpatient opthalmology surgery as a result of an accident	Covered	Covered	Covered	Covered	Covered
Inpatient non accident related eye treatment (excluding correction of refractive errors and laser treatment) (1 year waiting period)	100,000	100,000	100,000	100,000	100,000
Day case admission	Covered under relevant sub-limit	Covered under relevant sub-limit	Covered under relevant sub-limit	Covered under relevant sub-limit	Covered under relevant sub-limit
Medically necessary home nursing (subject to pre authorisation)	45 days	45 days	45 days	45 days	45 days
Post hospitalisation treatment/review – up to 3 weeks after discharge from hospital	up to Kes. 10,000	up to Kes. 15,000	up to Kes. 20,000	up to Kes. 25,000	up to Kes. 30,000
Take home prescribed medication after discharge from hospital	up to 30 days after discharge	up to 30 days after discharge	up to 30 days after discharge	up to 30 days after discharge	up to 30 days after discharge
OTHER BENEFITS INCLUDED WITHIN INPATIENT COVER
All benefits are subject to overall annual benefit unless specified otherwise. Benefits/treatment subject to pre authorisation
Medically necessary local road ambulance leading to admission in hospital	Covered	Covered	Covered	Covered	Covered
Commercial Air Evacuation out of Kenya (must be pre authorised) for inpatient treatment not available locally or not safe to undertake locally	Not applicable	Not applicable	Economy return fare only within Africa, India and Pakistan	Economy return fare only within Africa, India and Pakistan	Economy return fare only within Africa, India and Pakistan
Last Expense (free for principal member, optional for dependents).	50,000	50,000	75,000	100,000	100,000
Personal Accident (Free for principal member, optional for dependents over 18 years)	500,000	500,000	500,000	500,000	500,000
OUTPATIENT BENEFITS (OPTIONAL)
Annual limits per person only	50,000	50,000	80,000	100,000	150,000
Consultation fees for GP (doctors on panel)	Covered	Covered	Covered	Covered	Covered

Consultation fees for Specialist on referral only (doctors on panel)	Covered	Covered	Covered	Covered	Covered
Pathology, Xrays, MRI, CT Scan and other necessary diagnostic tests (pre authorisation required)	Covered	Covered	Covered	Covered	Covered
Prescription drugs and dressings upto a maximum of 30 days dosage	Covered	Covered	Covered	Covered	Covered
Pre -existing and/or chronic conditions, gynaecological conditions, Hernias, Haemorrhoids, Thyroidectomy, Adenoidectomy,Psychiatric, congenital, organ transplant, HIV/AIDS and related conditions existing/ not existing and/or not diagnosed at the time of joining. Subject to full disclosure at the time of joining. (1 year waiting period)	Covered	Covered	Covered	Covered	Covered
Cancer treatment (2 years waiting period)	Covered	Covered	Covered	Covered	Covered
KEPI/Baby Friendly Vaccinations Physiotherapy (pre authorisation required)	up to 5,000	up to 5,000 Covered	up to 5,000	up to 5,000 Covered	up to 5,000 Covered
	Covered	up to 5,000 Covered	Covered	up to 5,000 Covered	up to 5,000 Covered
Pre-natal & Ante-natal outpatient treatment (1 Year waiting period). Only applicable if maternity benefits have been purchased.	Covered up to 5,000	up to 5,000	up to 5,000	up to 5,000	up to 5,000
ROUTINE MATERNITY BENEFITS (OPTIONAL)
Annual limits per member/spouse	80,000	100,000	120,000	120,000	150,000
Benefits covered under maternity limit (1 year waiting period). Excludes expenses related to the new born	Normal and C-Section delivery. Labour/recovery ward, professional fees, pregnancy/ maternity related hospitalisation, other related ailments & complications including etopic pregnancy and miscarriage.
ROUTINE DENTAL BENEFITS (OPTIONAL) *
Annual Limit per person only	5,000	10,000	20,000	30,000	40,000
Benefits covered (pre-authorisation required)	Dental Consultations, Extractions, Fillings, Dental Xrays and Prescriptions. Removal of impacted or buried teeth and root canal treatment.
ROUTINE OPTICAL BENEFITS (OPTIONAL) *
Annual Limit per person only	5,000	10,000	20,000	30,000	40,000
Benefits covered subject to pre-authorisation	1 eye test per person per annum. Frames and prescription lenses
Frames limit (1 every 2 years)	Up to full optical limit		Kes. 10,000/- per frame
VALUE ADDITIONS
Automatic enrolment to Jubilee Health Insurance Wellness Club Free Jubilee Health Wellness Card (smart card)

Jubilee Medical Insurance PROVIDER PANEL

The provider panel for Jubilee Health Insurance gives members access to the essential medical care on a credit basis, which means that as long as the procedure is covered and pre-authorized as needed, the bill will be paid directly to the service provider within reasonable and customary timeframes. This enables members to receive high-quality care as needed.

The provider panel will be included in the membership box once the insurance is purchased, and it can also be accessible online through the customer portal or website of Jubilee Health Insurance. Members are also urged to register for this online portal, which will give them access to information on claims, medical benefits, and other topics.

Jubilee Medical Insurance Application for Coverage

Fill up and sign the member application form to request coverage. Send it in with the necessary supplemental documentation. After receiving your application, Jubilee Health Insurance will respond within 3 working days and confirm the terms and conditions in writing.

When the payment is fully paid, the policy will go into force. Where applicable, waiting periods will begin on the later of the policy’s effective date or the date the benefit is purchased.

Jubilee Health Insurance Overseas inpatient referrals

Jubilee Health Insurance covers treatment at overseas Hospitals. Many patients from Kenya travel to abroad for advanced medical treatment. Jubilee medical Insurance covers Inpatients bills for different types of treatment including Cancer, Bone Marrow Transplant, Kidney Transplant, Liver Transplant, Radiation Therapy, many advanced surgeries.

Jubilee Medical Insurance Key Benefits

According to the benefit options you selected and as described in the acceptance letter and policy document, you will be covered.

Your membership pack will include a list of providers and experts. The Jubilee Health Insurance website offers access to the same information. For more help, you may also contact our offices directly.

There will be a list of doctors and specialists available, and clients online or on the Jubilee Health Insurance website can also access it. Always keep your national ID or passport on hand for identification and verification, as well as your Jubilee Health Insurance medical card.

Some of the waiting periods may be waived, allowing for a smooth transition, subject to the underwriting procedures and with no disruption in cover.

Jubilee Medical Insurance treatment Abroad

If an emergency illness or accidental injury happens while travelling, a member is covered while temporarily overseas and in need of emergency treatment, provided that the total length of the trip does not exceed six weeks. This coverage is offered on a reimbursement basis. The expense of travel and lodging is not covered.