Sunday, December 25, 2016

Choosing the right Medical Insurance: Guide for Self-Employed Kenyans



For a Kenyan looking for individual and family medical insurance options, it is usually important to first identify your options before you can make valid comparisons and right choices. For instance, if your desire is to save money and get the most from your medical insurance investment, you will require the broadest possible view of available health insurance plans
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Find a Reputable Agent


 One of the best steps to finding Kenyan medical insurance companies is working with licensed and reputable agents. Trustworthy agents can help you to save time and get a wide selection of quotes from top medical insurance companies in Kenya. There are many Kenyan agent sites online that can provide you with free, instant medical insurance advice and quotes, making it easier for you to find the most suitable medical insurance plan for your budget and needs.

When selecting an insurance agent to work with, make sure to:
(a)     Pick a licensed Kenyan agent extensive experience working with Kenyan medical insurance companies and providers.
(b)     Choose an agent that does not require you to provide any sensitive personal information before you can access quotes.
(c)     Select an agent whose website provides instant personalized insurance quotes from a wide range of top carriers.
(d)     Choose an agent that provides side by side comparisons of different plan rates and benefits.
(e)     Work with an agent that offers reliable customer reviews and industry ratings of different insurance companies to guide your decision.
(f)      Select an agent with special online tools for generating personal recommendations based on your needs or that can help you to choose the best plan accepted by your favorite doctor.
(g)     Choose an agent that offers personal and unbiased help via phone, online chat and email.


Once you have picked your agent, you can work with him/her to identify a number of medical insurance companies that suit your needs. Prepare a list of at least 5 Kenyan medical insurance companies and then conduct thorough research regarding the plans, track record and reputation of these companies so you are able to make the right decision when picking your insurer.

Factors you should consider when choosing a medical insurance company:

Picking one insurance company from your list may be an overwhelming task. However, by considering the following 5 factors, you can easily narrow down your options and make the right decision. The factors include:

(a)     Health benefits of the plan
When comparing medical insurance plans from different Kenyan companies, make sure to pick out the plan that offers the must-have benefits you have identified. Purchase a plan that is both relevant and crucial to you and make sure to keep your costs as low as possible. It is also important to avoid plans offering expensive benefits, such as prescription drugs or maternity, if you don’t need such benefits.

(b)     Costs
The plan you choose should fall within your budget in terms of premium, copayments, coinsurance and deductibles. Choose a company providing a high-deductible plan if your main aim is to keep your monthly premium low.

(c)     Physician Network
If you have a favorite doctor or hospital, then you should choose an insurance company whose network of health care providers includes them. Start by finding out from your doctor or hospital which Kenyan insurance companies they work with. With this information, you can now narrow your options down to just the few insurers that have listed your favorite doctor or hospital.

(d)     Brands
Make sure that the Kenyan medical insurance company you pick does not work with brands that you want to avoid. Carefully examine a company’s list of brand-name carriers to find out if it has the names you prefer.

(e)     Consumer and Industry Reviews
Before you select a Kenyan medical insurance company, make sure you read consumer and industry reviews. There are several online reviews and ratings for medical plans sold in Kenya, which you can use to make the right choice.

Making Application for Medical Insurance

After selecting a medical insurance plan that suits your needs and budget, you should proceed to complete an application for coverage. You can either make the application online or visit the insurance company’s office to make an application. During the application, answer all the questions correctly, making sure the information provided is accurate and up-to-date. When not sure of any piece of information, wait until you have the right answers before you proceed with the application. For example, if you are unsure about your last checkup date, call your doctor’s clinic for the right information. It is better to provide correct information up-front than for you Kenyan insurance company to discover that you omitted specific elements of your medical history during application.


Once your application has been received by the insurance company, you will get one of the following responses:

(a)     You are approved: This means you have been authorized to enjoy the service. Your medical insurance coverage will begin on the “effective date” confirmed by the insurance company.

(b)     You are approved, with conditions: This means the insurance company will offer you coverage but with limits on the benefits for specific conditions depending on your medical history.

(c)     More information required: The insurance company requires more information regarding your application. Sometimes, the company will request for medical records from your doctor before making the final decision on the application.

(d)     Your application denied: In a scenario where you application has been denied, make sure to find a licensed insurance agent or professional to advice you. You may learn to appeal the decision or to make a new application with another medical insurance company. You may also opt for the state-backed national health insurance fund (NHIF).

What should you do after purchasing a plan?

Once the insurance company has approved you for coverage, you will receive official correspondence confirming the date on which the coverage begins. You are free to start enjoying the benefits of the coverage after that date. Also check the document sent to you to find the contacts of the customer service department or agent so you can know who to contact when you have questions.

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