The purpose of Health Insurance is to cover the costs of medical expenses, which can be expensive and unexpected.
In Kenya, medical insurance covers a variety of healthcare services, including hospital stays, surgery, and prescription medications. In the event that you or a family member become sick or injured and are unable to work, it can also protect you or your family from financial hardship.
The health insurance uptake in Kenya has been relatively low in the past, but it has been increasing in recent years. According to the World Bank, in 2017, only about 15% of the population in Kenya had some form of health insurance coverage.
However, the Kenyan government has been working to increase the uptake of health insurance through various initiatives, such as the National Health Insurance Fund (NHIF) and the Affordable Health Care initiative. These initiatives aim to provide affordable health insurance options to low-income households and increase access to quality healthcare services.
According to a study by Kenyatta University, 46.1% of people reported having health insurance, with the majority being NHIF members and working in the formal economy. Health insurance awareness was found to be 52.6%, which may be a significant role in the low uptake.
The following are some reasons why Kenyans should have medical insurance:
High healthcare costs:
There are a number of ways in which Kenyan health insurance can shield you from high medical costs. In order for your health insurance to cover your health expenses, you must typically pay a deductible, which is a set amount out of pocket.
Your insurance will typically cover a portion of your medical costs after you have met your deductible, and you will be responsible for paying the remainder.
In this example, if you have a medical expense of 10,000 KES and your deductible is 5,000 KES, you will need to pay the first 5,000 KES out of pocket. 80% of your remaining KES 5,000 may be covered by your insurance after your deductible is met, leaving you with KES 1,000 to pay.
You may also be able to access care more easily if you have health insurance, as many healthcare providers require insurance before providing treatment. It can be financially burdensome to pay for medical care out of pocket without insurance.
As a whole, health insurance can help you afford care by providing financial assistance and covering a portion of your medical expenses.
Access to Quality Healthcare
Many Kenyans still lack access to quality medical care, especially in rural areas, despite significant efforts to expand access to healthcare. In the event that you need medical care, health insurance can help you obtain it when you need it.
The cost of medical treatment in Kenya can be paid for by health insurance, ensuring quality healthcare. The deductible is the amount you have to pay before your health insurance begins to reimburse you for your hospital expenses.
A portion of your medical costs will usually be covered by your insurance after you have met your deductible. This is followed by the remaining balance being covered by your copays or coinsurance.
Many healthcare providers will require you to have insurance to receive treatment, so having health insurance can make access to care easier. If you don’t have insurance, you may have to pay for medical care out of pocket, which can be financially burdensome and prevent you from seeking help.
Furthermore, health insurance can provide you with access to a network of healthcare providers, such as hospitals, clinics, and specialists, vetted and approved by your insurer. Providers who meet certain standards of care and are committed to providing the most effective treatment can help ensure that you receive high-quality care.
By providing financial assistance to cover medical treatment costs and giving you access to vetted healthcare providers, health insurance can help guarantee quality healthcare in Kenya.
Unexpected medical expenses
If you or a family member become sick or injured, medical insurance can help protect you against unexpected costs. When you have medical insurance, you must usually pay a deductible, which is a set amount that you must pay before your insurance starts paying for your medical costs. After you have met your deductible, your insurance will typically cover a portion of your medical costs, with you covering the remaining balance through copayments or coinsurance.
Medical insurance can help protect you from unexpected costs by covering a portion of your hospital costs and alleviating the financial burden of unexpected health bills. Additionally, it can provide financial protection if you or a family member become ill or injured and are unable to work. This is because it can cover the cost of medical treatment.
Medical insurance helps protect against unexpected costs by providing financial assistance for medical treatment and ensuring that you have access to care.
By covering the costs of medical care in case of sickness or injury, medical insurance can provide protection against financial hardship.
In Kenya, healthcare insurance can help cover the costs of medical treatment, which can be expensive and unexpected. A deductible is an amount you must pay before your insurance begins to cover your medical expenses when you have health insurance. After you have met your deductible, your insurance will typically reimburse a portion of your treatment costs, with you paying the remaining balance through copayments or coinsurance.
You or a family member may suffer financial hardship if they become ill or injured and cannot work due to their illness or injury. Getting medical treatment can be expensive, and if you do not have health insurance, you may have to pay for it yourself, which can be financially burdensome. In addition to covering these costs, medical insurance can provide financial protection as well.
Furthermore, medical insurance will provide you with access to quality health care when you need it. In the absence of insurance, you may be unable to afford necessary treatment or may be forced to forgo treatment due to financial constraints. Medical insurance can help ensure that you have access to the care you need, which can be especially helpful in cases of serious illness or injury.
By covering medical treatment costs and providing access to care, medical insurance can offer financial protection in Kenya.
Dental and Eyecare Coverage in Health Insurance: a few things to note
Dental and eyecare services are sometimes covered by Kenyan health insurance plans. Coverage like this can cover the cost of treatments and procedures like teeth cleanings, fillings, and extractions for dental care. It can also include eye exams, glasses, and contact lenses for eye care.
Comprehensive health insurance plans may include dental and eye care coverage or they may be available as an optional add-on to basic health insurance plans. You should carefully review your health insurance plan to understand what services are covered and to what extent.
The cost of dental and eyecare services might not be covered by your health insurance. However, you may still be able to purchase separate insurance policies to cover these expenses. If you are considering buying an insurance policy, be sure to carefully read the terms and conditions to understand what they include.
Dental and eyecare coverage can be an invaluable consideration when choosing a health insurance plan in Kenya, since these services are expensive and not always covered by basic plans.
The following are some Setbacks to keep in mind
When it comes to medical insurance in Kenya, there are a few cons to consider:
Expensive Comprehensive Insurance Cover
A comprehensive medical insurance plan can be expensive, especially if you want to cover a wide range of services. Some individuals or families may have difficulty affording insurance, especially if they have a limited income or are already struggling financially.
Copayments and deductibles
You may be required to pay a deductible before your medical insurance begins to cover your expenses. In addition, you may be required to pay copayments or coinsurance for some services, which can add to the overall cost of your medical care.
There may be limitations to the coverage of certain types of treatments or procedures under some medical insurance plans. To understand what your insurance plan covers and what it doesn’t, you should carefully review the terms.
Limited Health Insurance Cover
In some cases, you may not be able to access care if your insurance only covers a limited network of healthcare providers. This can make it difficult to find a provider who is covered by your insurance and who is able to provide the care you need.
Considering the pros and cons of medical insurance in Kenya is crucial before purchasing a policy. It is helpful to understand the benefits and drawbacks of medical insurance since it can provide both financial protection and access to care.
For anyone living in Kenya, medical insurance can provide financial protection as well as ensure access to quality medical care when necessary. Need to get started by investing in health insurance? Contact Blossom Insurance Agency today, and let us help you secure yourself and your loved ones.