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Compare Health Insurance in Kenya — Without Claim Surprises

Protecting your health shouldn’t be confusing or expensive. At Amssurity, we compare major Kenyan and international health insurance plans side by side in plain English. Tell us your needs (individual, family, maternity, chronic care), get real-time quotes and visual breakdowns, and receive a personal advisor via WhatsApp or email, so you can choose confidently, enrol easily, and manage your cover seamlessly all in under 30 seconds..

Get a Quote

Get the best health insurance in Kenya.

To get the best health insurance in Kenya will mean that you will understand what medical insurance covers, what benefits are available to you, and the best benefits for you.

Why Most Health Insurance Policies Fail at Claim Time

The Failure

What Amssurity does

Hidden sublimits that appear after diagnosis

We name every sublimit in your plan brief, cancer cover, chronic conditions, maternity cap, optical/dental, before you sign

Waiting periods no one explained

We show the exact waiting period per benefit, per insurer, including the C-section wording

"Covered" conditions quietly excluded

We flag exclusion clauses specific to your health history, not the generic list

Networks that don't include your hospital

We verify your preferred hospital against each insurer's actual panel before you compare

Brokers who disappear at claim time

We open your claim within 2 hours and follow up with the insurer every 48–72 hours until resolved

None of this is accidental. It’s what happens when policies are sold instead of understood.

Protect yourself in the event of...

Inpatient cover

This covers all medical costs related to your hospital stay. Such costs include:

Bed costs
Diagnostic tests
Doctors and specialist fees
Surgical fees

Outpatient Cover

This covers all related medical costs that don't require a hospital stay. Such costs include:

Diagnostic tests
Doctors and specialist consultation fees
Prescription medication

Maternity Cover

This covers all medical costs related to childbirth. Such costs include:

Bed costs
Cost of delivery
Anaesthetists and paediatrician charges

Compare Health Insurance Plans in Kenya

Q: How do co-pays and sub-limits work?

Co-pays are fixed amounts you pay at service; sub-limits cap specific benefits inside the overall limit (e.g., dental, optical).

Q: How do I file a claim?

Message us on WhatsApp or email; we open the claim within two business hours, share a checklist, and follow up with the insurer until resolution.

Get 3 matching quotes and a one-page plan brief in 24 hours. Claims concierge on WhatsApp when you need it.

Get My Quote Talk to an Advisor Try the Health Insurance Calculator

Claims Concierge

24-Hour Quote Pack

Plain English Plan Brief

Purshottam Place, Westlands

Which plan is right for you?

Individuals

Tailored outpatient and inpatient options, verified hospital networks, clear co-pays and sub-limits, fast WhatsApp claims kickoff.

Families

Maternity and paediatric coverage with transparent waiting periods, flexible outpatient limits, easy dependant onboarding for you.

SMEs

Group rates, digital onboarding, utilization dashboards quarterly, concierge support with escalation for timely claim follow-ups.

Expatriates

Regional and international networks, direct billing at key hospitals, evacuation options, flexible territory and currency choices.

Start My Quote Ask an Advisor Estimate with Calculator

Side-by-Side Comparison

Key features at a glance. We’ll tailor options and fine print in your one-page brief.

Feature (Ksh)	Old Mutual Afya Imara	Madison Betterlife Executive	AAR Bronze
Inpatient	1,000,000	1,000,000	1,000,000
Outpatient	60,000	100,000	75,000
Maternity	75,000	100,000	75,000
Copay	500–2,000	1,000	500
Chronic conditions	Cover to 400,000	Cover to 300,000	Cover to 300,000
Premium as from	5,629 / month	5,614 / month	4,923 / month
Hospitals	Tiers 1, 2 & 3	Tiers 1, 2 & 3	Tiers 1, 2 & 3

Estimate with Calculator Download Full Comparison (PDF)

How SHIF (formerly NHIF) works alongside private medical cover

SHIF handles statutory coverage; private cover expands networks, benefits, and limits.
We help structure both so you avoid gaps and duplication.
Clear guidance for HR and individuals during onboarding and renewal.

Get Coordinated Cover Read the SHIF Guide

Why Amssurity

24-Hour Quote Pack, WhatsApp Claims Concierge, transparent comparisons.

Get My Quote Book a Consultation

How claims work (simple & fast)

1) Message us. Send WhatsApp or email with basics (date, provider, brief).

2) Kickoff in 2 hours. We open the claim and share a checklist.

3) We do the chasing follow-ups with the insurer every 48–72h.

4) Resolution: We confirm settlement or next actions.

Health Insurance FAQs

Are pre-existing conditions covered?

Coverage varies by insurer and plan. Many plans include coverage after a waiting period or with specific disclosures. We’ll show you which options match your condition and the documentation required.

What are typical waiting periods (e.g., maternity)?

Waiting periods differ by benefit and insurer. Maternity often has a longer waiting period than outpatient benefits. We’ll surface the exact periods in your comparison brief before you buy.

Which hospitals are in-network?

We verify your preferred hospitals and clinics against each insurer’s panel and include a link to the provider list in your quote pack.

How do co-pays and sub-limits work?

Co?pays are fixed amounts you pay at service; sub?limits cap specific benefits inside the overall limit (e.g., dental, optical). Your brief shows both, so there are no surprises at claim time.

How does SHIF affect private medical insurance?

SHIF is the statutory cover. Your private plan complements SHIF to expand networks and limits. We’ll advise how to structure both for your needs. Read our 2?minute SHIF guide.

How do I file a claim?

Message us on WhatsApp or email with the basic details; we open the claim within two business hours, share a checklist, and follow up with the insurer until resolution.

Ready to compare your options?

Get three tailored quotes and a plain English plan brief in 24 hours.

Get My Quote Estimate with Calculator

Timelines depend on complete requirements and insurer responsiveness.

What to check	APA Jamii Plus 1M	Old Mutual AfyaImara 1M	Heritage HeriAfya 1M	CIC Comprehensive 1M	Jubilee JCare Premier 1M
Inpatient Cover
Overall annual limit	KES 1,000,000	KES 1,000,000	KES 1,000,000	KES 1,000,000	KES 1,000,000
Bed entitlement	Private Room up to KES 12,500/night	General Ward up to KES 10,000/night	General Ward	General Ward	Private Room up to KES 12,500/night
Sublimits — What the Premium Doesn't Tell You
Pre-existing & chronic conditions sublimit	KES 300,000 after 12 months	KES 400,000 after 1 year	KES 400,000 after 1 year	KES 350,000 after 1 year	KES 300,000 after 1 year
Cancer treatment sublimit & waiting period	Within pre-existing limit (KES 300K) after 12 months. + Femina Plus: cash payout up to KES 1.25M for female members (by cancer stage)	Within pre-existing limit after 1 year. + Critical Illness lump sum KES 750,000 (cancer, stroke, heart attack, kidney failure, paralysis — 28-day wait. Separate from main limit.)	KES 350,000 2-year waiting period	KES 350,000 1-year waiting period	KES 300,000 2-year waiting period
Maternity sublimit & waiting period	Optional add-on KES 50K–250K 10-month wait	KES 75,000 Inbuilt. 1-year wait. Includes elective C-section & complications.	Within inpatient 10-month wait	KES 80,000 Inbuilt. 10-month wait. Includes C-section.	Optional add-on KES 100,000 1-year wait
Hospital Access — What Your Card Actually Unlocks
Nairobi Hospital copay per outpatient visit	? Accessible KES 1,500 copay	? Accessible KES 2,000 copay	? Accessible KES 2,000 copay	? NOT accessible CIC Comprehensive, Standard & Essential plans cannot access Nairobi Hospital, MP Shah, Aga Khan, Gertrude's, Mater, or AAR for outpatient. Stated in the benefit schedule.	? Accessible KES 2,000 copay
Aga Khan / MP Shah copay per outpatient visit	? Accessible KES 1,500 copay	? Accessible KES 2,000 copay	? Accessible KES 2,000 copay	? NOT accessible	? Accessible KES 2,000 copay
Indicative Annual Premium — Inpatient Only
Couple (ages 35 + 32) + 1 child Inpatient only. Outpatient, dental & maternity are additional. Per brochure rate cards — confirm with Amssurity.	KES 72,468 /yr ≈ KES 6,039/mo	KES 79,110 /yr ≈ KES 6,593/mo	KES 73,440 /yr ≈ KES 6,120/mo	KES 68,396 /yr ≈ KES 5,700/mo	KES 63,088 /yr ≈ KES 5,257/mo
Amssurity Advisory Verdict — Who This Plan Suits and Who It Doesn't
Our advisory read	Good fit for healthy families with no known conditions who want private room access at 1M. Female buyers benefit significantly from the inbuilt Femina Plus cancer staging payout — this alone can be worth more than the premium difference. Not the plan if you're planning maternity in the next 12 months.	The Critical Illness lump sum (KES 750K, covers cancer, stroke, heart attack, kidney failure, paralysis) is the standout feature in this bracket — it pays out separately from your main inpatient limit. Best overall package for a family buying at 1M, particularly where chronic illness history exists. Premium is highest here, but the lump sum benefit changes the real value equation.	Solid mainstream choice. Hospital access is unrestricted (with copay). Cancer sublimit of KES 350K at the 2-year mark is comparable to peers. Good for families who want broad access without the premium of Old Mutual's lump sum feature. Not the plan if cancer diagnosis is a near-term concern — 2-year wait is the industry standard here.	Stop before you buy this plan for a family that uses Nairobi Hospital, Aga Khan, MP Shah, Gertrude's, Mater, or AAR for outpatient care. The CIC Comprehensive plan explicitly excludes Tier 1 hospital access for outpatient treatment. If your preferred hospital is on that list, you will pay full cash out of pocket every outpatient visit. CIC Comprehensive is appropriate only for families whose primary outpatient providers are outside the Tier 1 list. The premium saving does not compensate for this restriction if you use these hospitals.	Lowest premium in this bracket — but the pre-existing/chronic sublimit of KES 300,000 is also the lowest. If you or a family member has a managed chronic condition, this sublimit will be exhausted faster than the alternatives. Suitable for healthy families under 40 with no known conditions and a clear cost priority. Private room access at 1M is a plus. The Dec 2023 rate card is outdated — get a current quote.

What to check

APA
Jamii Plus 1M

Old Mutual
AfyaImara 1M

Heritage
HeriAfya 1M

CIC
Comprehensive 1M

Jubilee
JCare Premier 1M

Inpatient Cover

Overall annual limit

KES 1,000,000

Bed entitlement

Private Room
up to KES 12,500/night

General Ward
up to KES 10,000/night

General Ward

Private Room
up to KES 12,500/night

Sublimits — What the Premium Doesn't Tell You

Pre-existing & chronic conditions sublimit

KES 300,000
after 12 months

KES 400,000
after 1 year

KES 350,000
after 1 year

KES 300,000
after 1 year

Cancer treatment sublimit & waiting period

Within pre-existing limit (KES 300K) after 12 months.
+ Femina Plus: cash payout up to KES 1.25M for female members (by cancer stage)

Within pre-existing limit after 1 year.
+ Critical Illness lump sum KES 750,000 (cancer, stroke, heart attack, kidney failure, paralysis — 28-day wait. Separate from main limit.)

KES 350,000
2-year waiting period

KES 350,000
1-year waiting period

KES 300,000
2-year waiting period

Maternity sublimit & waiting period

Optional add-on
KES 50K–250K
10-month wait

KES 75,000
Inbuilt. 1-year wait. Includes elective C-section & complications.

Within inpatient
10-month wait

KES 80,000
Inbuilt. 10-month wait. Includes C-section.

Optional add-on
KES 100,000
1-year wait

Hospital Access — What Your Card Actually Unlocks

Nairobi Hospital copay per outpatient visit

? Accessible
KES 1,500 copay

? Accessible
KES 2,000 copay

? NOT accessible
CIC Comprehensive, Standard & Essential plans cannot access Nairobi Hospital, MP Shah, Aga Khan, Gertrude's, Mater, or AAR for outpatient. Stated in the benefit schedule.

? Accessible
KES 2,000 copay

Aga Khan / MP Shah copay per outpatient visit

? Accessible
KES 1,500 copay

? Accessible
KES 2,000 copay

? NOT accessible

? Accessible
KES 2,000 copay

Indicative Annual Premium — Inpatient Only

Couple (ages 35 + 32)
+ 1 child Inpatient only. Outpatient, dental & maternity are additional. Per brochure rate cards — confirm with Amssurity.

KES 72,468 /yr
≈ KES 6,039/mo

KES 79,110 /yr
≈ KES 6,593/mo

KES 73,440 /yr
≈ KES 6,120/mo

KES 68,396 /yr
≈ KES 5,700/mo

KES 63,088 /yr
≈ KES 5,257/mo

Amssurity Advisory Verdict — Who This Plan Suits and Who It Doesn't

Our advisory read

Good fit for healthy families with no known conditions who want private room access at 1M. Female buyers benefit significantly from the inbuilt Femina Plus cancer staging payout — this alone can be worth more than the premium difference. Not the plan if you're planning maternity in the next 12 months.

The Critical Illness lump sum (KES 750K, covers cancer, stroke, heart attack, kidney failure, paralysis) is the standout feature in this bracket — it pays out separately from your main inpatient limit. Best overall package for a family buying at 1M, particularly where chronic illness history exists. Premium is highest here, but the lump sum benefit changes the real value equation.

Solid mainstream choice. Hospital access is unrestricted (with copay). Cancer sublimit of KES 350K at the 2-year mark is comparable to peers. Good for families who want broad access without the premium of Old Mutual's lump sum feature. Not the plan if cancer diagnosis is a near-term concern — 2-year wait is the industry standard here.

Stop before you buy this plan for a family that uses Nairobi Hospital, Aga Khan, MP Shah, Gertrude's, Mater, or AAR for outpatient care. The CIC Comprehensive plan explicitly excludes Tier 1 hospital access for outpatient treatment. If your preferred hospital is on that list, you will pay full cash out of pocket every outpatient visit. CIC Comprehensive is appropriate only for families whose primary outpatient providers are outside the Tier 1 list. The premium saving does not compensate for this restriction if you use these hospitals.

Lowest premium in this bracket — but the pre-existing/chronic sublimit of KES 300,000 is also the lowest. If you or a family member has a managed chronic condition, this sublimit will be exhausted faster than the alternatives. Suitable for healthy families under 40 with no known conditions and a clear cost priority. Private room access at 1M is a plus. The Dec 2023 rate card is outdated — get a current quote.

Motor Insurance Quote

Your car

Your details:

Health Insurance Quote

Your details:

Your Family:

Travel Insurance Quote

Destination:

Trip Start Date to Trip End Date:

Your details:

Your Family:

Health Insurance

Compare Health Insurance in Kenya — Without Claim Surprises

Get Quote Today

Get the best health insurance in Kenya.

Why Most Health Insurance Policies Fail at Claim Time

Protect yourself in the event of...

Inpatient cover

Outpatient Cover

Maternity Cover

Compare Health Insurance Plans in Kenya

Which plan is right for you?

Individuals

Families

SMEs

Expatriates

Side-by-Side Comparison

How SHIF (formerly NHIF) works alongside private medical cover

Why Amssurity

How claims work (simple & fast)

Health Insurance FAQs

Ready to compare your options?

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