Octagon Africa

AFYA PLUS POST-RETIREMENT MEDICAL COVER

Afya Plus Post-Retirement medical cover provides a medical cover for you and your loved ones after you retire from active employment. This cover pays for your medical expenses during hospital visits and admission. The cover also pays for rescue and evacuation in cases of emergency giving you and your loved ones peace of mind in retirement.

How do I pay for my premiums?

During your employment, part of your pension is collected and saved in a fund to pay for your medical insurance premiums after retirement.

You no longer have to worry about healthcare during retirement as Afya Plus seeks to ensure you enjoy retirement blissfully and what’s more? You enjoy a wide variety of medical services providers under this cover.

Inpatient Benefits

Plan Plan A Plan B Plan C
Overall Limit 1,000,000 2,000,000 5,000,000
Inpatient Sublimit
Bed Limit General Standard Private Room (Kshs. 12,500) En suite Room (Kshs. 18,000)
Pre-existing, chronic, HIV/AIDS, cancer, congenital and related complications 350,000 450,000 500,000
Newly diagnosed after 180 days of cover
All Surgeries – Gynaecological, implants, appliances, joint replacement, prosthesis & reconstructive surgery 300,000 400,000 400,000
Organ Tranplant 350,000 500,000 500,000
Psychiatry & Psychotherapy 300,000 300,000 300,000
Inpatient Illness (dental & optical) 100,000 100,000 100,000
Post Hospitalization 25,000 25,000 25,000
Last Expense 75,000 75,000 75,000
Road & Air Evacuation Full Limit Full Limit Full Limit
Waiting Periods (months)
Accident 0 0 0
Acute illness 1 1 1
Illness surgery 3 3 3
Pre-existing, chronic, HIV/AIDS, congenital and related complications 12 12 12
Cancer, renal failure 24 24 24
All Surgeries – Gynaecological, implants, appliances, joint replacement, prosthesis & reconstructive surgery 12 12 12
Organ Transplant 12 12 12
Psychiatry & Psychotherapy 12 12 12
Inpatient Illness (dental & optical) 12 12 12

Inpatient rates

Premium per age band 1,000,000 2,000,000 5,000,000
AGE BAND M M+1 M M+1 M M+1
50-59 42,120 77,357 51,300 94,206 106,288 181,338
60-69 66,690 119,639 81,135 140,824 176,200 292,945
70-79 85,860 156,214 104,355 196,435 277,371 463,990
Additional dependants (aged less than 18) 15,006 17,981 41,046

Outpatient Benefits

Overall Limit
Outpatient Sublimit
Primary consultations and treatment to include medical practitioner’s fees, prescribed medicines, drugs and dressings 100% in Network
X-rays, pathology, diagnostic tests & procedures
Specialists & Consultation fees for consultations, prescribed medicines, drugs and dressings
100% in Network
Physiotherapy by registered physiotherapist, when referred by a medical practitioner or consultant or specialist 100% in Network
Dental Kshs. 10,000
Optical Kshs. 10,000
Pre-Existing & Chronic medication 50% of annual limit

Outpatient rates

Outpatient Premium (Per Person) – Age Based 200,000 100,000
With visit of Kshs. 500
50-59 69,795 64,176
60-69 110,407 91,731
70-79 168,431