The last thing you want when you or a family member is sick is the stress of trying to pay for medical expenses
We do health insurance differently - with more coverage,
less hassle, and perks that give you the most out of your premium.
POLICY LIMITS
- Hospital bed accommodation charges (minus NHIF rebate amount)
- Pre existing conditions are declared and accepted
- Diagnostics for member and spouse
- Major organ transplant procedure
- In- patent prescribed physiotherapy, chemotherapy, radiotherapy, nursing care, prescribed drugs/medicine, dressing and diagnostic test.
- Non-accident maxillofacial and ophthalmologic, dental surgery subject to authorization.
- Day care surgery
- Resident mother/doctors fee
POLICY LIMITS
The policy Limits range from ksh 300,000 to ksh 5,000,000 and comes in six packages.
Amount (KES)CIC Package
- 5,000,000
- 3,500,000
- 2,000,000
- 1,000,000
- 500,000
- 300,000
- Prestige
- Premier
- Superior
- Compresive
- Standard
- Essential
Why Seniors Mediplan
This is a medical cover designed for senior citizens who are the most vulnerable to illness, pain and related medical conditions. The cover protects them against medical expenses and gives them comfort in old age.
Medical Cover built for Comfort in Old Age.
MEMBERSHIP ELIGIBILITY & ONBOARDING
Eligibility for Principal Member and Spouse is from 60 years to 80 years. No limit once joined. The cover allows only one legal spouse as a dependant of the principal member. Additional spouses can be included on the cover as principal members.
Child dependents are not eligible under this cover. The alternative cover is provided under the CIC Family Medisure cover.
All new applicants will be required to submit a medical report before membership and eligibility of cover can be confirmed. The cost of the medical examination is borne by the applicant at a hospital appointed by CIC.
Existing members can continuously renew their membership without age restrictions.
BENEFITS SUMMARY
- In-Patient
- Outpatient
- Dental
- Optical
- Last expense
- Chronic cover
- Geriatric panel
- Annual health checks
- Organ transplant
- Covid-19
- The product also offers a last expense cover in the event that the insured person passes on as a result of covered conditions while the cover is in force
Frequently Asked Question on CIC Seniors Mediplan
What options are there for payment in installments?
- Premium is paid in full before cover commencement.
- IPF is available – maximum of 4 instalments.
What is covered?
- Inpatient
- Outpatient
- Dental & Optical
- Last Expense
- Covid – 19
Who can join?
- Joining age is between the ages of 60 – 80 years
- Principal Member and Spouse cover
- After 80 years you can renew for life
What is the waiting period?
- 30 days for outpatient and acute illness admissions.
- 1 year for pre-existing and chronic conditions, gynaecological surgery, Psychiatric illness/ psychotherapy, Ophthalmologic surgery & Dental surgery treatment for both inpatient and outpatient.
- 2 years for cancer and related treatments for both inpatient and outpatient.
- 3 years for organ transplant.
- 3 years for Reconstructive surgery.
- There is no waiting period for accident cases.
What are the cover terms?
- Co-payment schedule per Hospital for Outpatient services applies
- List of service provider panel available (0ver 900 providers across Kenya)
- All Covid test must be preauthorized and prescribed by a Doctor under the Outpatient benefit.
- Membership is subject to Underwriting.
Can waiting periods be waived if I am transferring from another insurer?
The following documents will be required for review and advise on waiver of waiting periods – Waiting periods will be waived for members transiting within 30 days from another insurance underwriter or their
respective Corporate Medical Schemes subject to performance review and approval of waiver in writing;
- The renewal invite from the other insurer with the terms
- The claims utilization statement stamped by the previous insurer
- Medical examination report (CIC will issue a medical examination letter upon review of the above)
Pre-requisite to joining– requirements for onboarding?
- Dully completed and signed application form
- Medical Examination Report – Upon receipt of the application form, CIC will issue you with medical examination letter. Cost of medical examination is borne by the member.
- ID/Passport for both principal and spouse
- KRA PIN for principal member
What are the limits covered?
Inpatient (300,000 – 5M) per family
Outpatient (50,000 – 200,000) per person
Dental (15,000 – 20,000) per person
Optical (15,000 – 20,000) per person
Last Expense (50,000 – 100,000) shared Principal and Spouse
Does the cover cater for flight incase of overseas treatment?
This is payable under economy class within the inpatient limit if the member has been referred by CIC.
What happens when someone gets to the maximum age while still on cover?
Existing members can continuously renew their membership without age restrictions.
What is the premium payable?
Age banded premiums based on the age of the older member between the principal and the spouse.
