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Category:
JOBGROUPSA-M,DISCIPLINEDSERVICES-PG1-9ANDSTATECOUNSEL-SL1-3
PeriodofCover: TBA
Tableofbenefits
Civil
Servants/TSC
Secretariat
JobGroups
Disciplined
Services
Grades
State
Council
Grades In-patient
Out-
patient LifeCover
Critical
Illness
Last
expense Population
A-G PG1,2,3 - 500,000 50,000 150,000 37,500 30,000 129,902
H PG4 - 550,000 50,000 150,000 37,500 30,000 20,388
J PG5 - 600,000 55,000 150,000 37,500 30,000 19,333
K PG6 SL1 700,000 60,000 200,000 50,000 40,000 27,086
L PG7 SL2 900,000 70,000 250,000 62,500 40,000 10,957
M PG9 SL3 1,000,000 70,000 250,000 62,500 50,000 4,761
Totals 212,427
InpatientCover:
Provides for medically necessary:-
Hospital bed charges(wardbed) Doctors bills
Anesthetistsbills
Operatingtheatrefees Pharmacy Laboratoryand investigations
OutpatientCover:
Outpatient cover provides for
Doctors Consultation, All laboratory tests,
RadiologicalTests(x-ray,MRIandCTscan), Prescriptions &
Dressings, AllOut Patient proceduresandpharmacy
DentalCover
TheDentalcoverprovidesforcostoffillings,x-rays,extractionsincludingsurgicalextraction
togetherwithanestheticfeesuptoamaximumofKshs10,000
OpticalCover
TheOpticalcoverprovidesforthecostofeyeglassesandeyetesting(eyeglassesarelimitedto
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SpecialClauses
Nowaitingperiodfornewemployees(subjecttowrittennotification)
Emergency Inpatient dental and optical will be covered within the
inpatientlimit.
Inpatientdentalandopticalhospitalizationresultingfromanillness(apartfromLasereye
Surgery)willeachbecoveredwithintheinpatientlimit.
Claims relatedtoexpenses arising whilsttheMember
istemporarilyabroadandrequiringemergency treatment for an illness
or injury that occurs during theperiodoftravel
providedthatsuchperioddoesnotexceedsixweeksinanyonevisit will be
coveredon
reimbursement. Travel andaccommodationcosts arenotcovered.
Treatmentcostsarising from a condition that requires referral
treatmentoverseasbecause the treatment is not available in Kenya
will be covered onreimbursement
andSHALL requirepre-authorization.
Noreimbursementclaims
MemberEligibility
Employees actively in service between the ages of 18 years and
70 years shall beeligibleforcover.
Dependentchildrenareeligibleforcoverfrom0month(atermbabyof38weeks)ofageuptillthe
age of 18 years or to the age of 23 years if enrolled full-time in
arecognized
post-secondary institution.
