Tips to Help Kenyan Self-Employed Persons Understand Their Medical Insurance Needs

Self-employed Kenyans are individuals who are in businesses for themselves, typically operating without employees. Many such Kenyans work from their homes; some are graphic designers, consultants, tutors, web engineers, bloggers, brokers, agents, and kiosk owners, among others. They pursue business ideas of their own and pay for their medical expenses directly.
In Kenya, self-employed persons usually purchase individual and family medical insurance coverage.

Here are questions to help self-employed Kenyans can understand their insurance needs:

(a)     Who will be covered in my medical insurance plan?

While this question may sound dumb and you probably already know that you intend to cover yourself and your dependants, it is still important to know whether any member of your family has other coverage options and to prioritize who to cover if you can’t afford coverage for everyone. In some cases, it is cheaper to cover different family members separately under two or more plans.

(b)     Do you run a savings account or do you survive on payday to payday basis?

If you don’t have a cushion of funds in your bank account, you should opt for a medical insurance plan with a low deductible (or none at all). But if you maintain a savings account and can afford higher deductible, you can go for a plan with lower monthly premiums.

(c)     How often do you visit the doctor per year?

If you visit the doctor frequently, you should pick an insurance plan with a higher monthly premium so you can keep the deductible and copayment for your visits low. But if you rarely visit the doctor, you may choose to ignore coverage for preventive care.

(d)     How much did you spend in medical costs last year?

If you spend a lot of money in medical care, you need to know what you spend on and whether you expect similar expenses at the same pace. For example, if your expenses are recurrent (such as prescription drugs), choose a plan that covers the services. Don’t spend a lot of health care when you can do with a plan that offers less generous coverage for prescription drugs or clinic visits.

(e)     Are you suffering from any pre-existing medical condition?

Certain pre-existing medical conditions such as cancer, diabetes and heart disease can reduce your chances of getting approved for individual and family medical coverage. If you have a problem, find a licensed agent or broker to help you with your application.

(f)      Are you eligible for group medical insurance coverage?

While there are rare group medical insurance offers for self-employed persons in Kenya, some companies allow people with business licenses to purchase group/small business plans, even without workers. Research thoroughly and you will find the right offers for your needs.

(g)     Are any specific benefits relevant or unnecessary?

If you use prescription medication regularly, make sure to choose a plan that covers prescriptions at an affordable copayment level. Pay close attention to maternity benefits if you or your spouse has plans to become pregnant. Conversely, you should avoid a plan with prescription drugs or maternity benefits if they are irrelevant. This way, you can save money.