Old Mutual Afyaimara County Cover: Complete Benefits, Costs & Who Should Enroll
Afyaimara County Cover: Comprehensive Family Health Insurance
Protecting your family’s health shouldn’t be complicated or unaffordable. Old Mutual’s Afyaimara County Cover offers comprehensive medical insurance designed specifically for Kenyan families. With flexible options, extensive coverage, and affordable premium rates, this plan ensures you get quality healthcare when you need it most.
In this detailed guide, we’ll explore everything you need to know about Afyaimara County Cover – from benefits and coverage options to eligibility requirements and premium costs. Discover how this insurance solution can provide peace of mind for your family’s healthcare needs.
Key Takeaways
- Family-Focused: Comprehensive coverage for parents and children (0-18 years)
- Flexible Options: 4 inpatient options and 3 outpatient packages to match your budget
- Chronic Condition Coverage: Includes HIV/AIDS, cancer, and pre-existing conditions after waiting periods
- Wide Hospital Network: Access to hospitals across East Africa with overseas referrals
- Affordable Premiums: Starting from Ksh 11,184 annually for principal members
- Specialized Benefits: Maternity, optical, dental, and emergency evacuation coverage
Table of Contents
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Join WhatsApp Group NowWhat is Afyaimara County Cover?
Afyaimara County Cover is a specialized family medical insurance solution offered by Old Mutual Kenya. Designed with Kenyan families in mind, this comprehensive plan provides both inpatient and outpatient coverage at affordable rates. The “Afyaimara” name meaning “Strong Health” in Swahili reflects its mission to strengthen families’ healthcare security.
Why Families Choose Afyaimara County Cover:
- Tailored for Kenyan households with coverage for parents and children
- Chronic condition coverage including HIV/AIDS and cancer
- Maternity benefits with comprehensive packages for delivery
- East African coverage with emergency evacuation services
- Flexible payment options with installment plans available
Key Features & Benefits
Afyaimara County Cover stands out with its comprehensive benefits designed to address the specific healthcare needs of Kenyan families. Here are the standout features:
Wide Coverage
Access to selected hospitals within Old Mutual’s extensive East Africa network. Overseas referral available for conditions not treatable locally.
Emergency Services
Road evacuation for all plans and air evacuation for covers of Ksh 1M. Overseas emergency treatment coverage for 42 days.
Affordable Options
No excess for inpatient cover, installment premium payments, and no claim discount (NCD) available.
Comprehensive Benefits
Covers pre-existing conditions, HIV/AIDS, prematurity, neonatal conditions, maternity, dental, and optical services.
Specialized Coverage Areas
Afyaimara County Cover provides exceptional protection in critical healthcare areas:
- Chronic Conditions: Coverage for pre-existing conditions after 1-year waiting period
- Maternity: Comprehensive packages covering normal delivery, C-sections, and complications
- Child Health: Well-baby clinics and coverage for children up to 18 years
- COVID-19: Special coverage for moderate and critical COVID-19 cases
- Emergency Care: Road and air ambulance services depending on plan
Inpatient Coverage Options
Afyaimara County Cover offers four inpatient options with increasing coverage limits and benefits. All inpatient coverage includes hospitalization, surgery, ICU/HDU fees, and more.
| Coverage Area | Option 1 | Option 2 | Option 3 | Option 4 |
|---|---|---|---|---|
| Overall Limit | 100,000 | 250,000 | 500,000 | 1,000,000 |
| Hospital Accommodation | General Ward (Max 8,000) | General Ward (Max 8,000) | Private Room (Max 8,000) | Private Room (Max 14,000) |
| Chronic Pre-existing Conditions | 50,000 | 50,000 | 300,000 | 400,000 |
| Organ Transplant | 50,000 | 50,000 | 200,000 | 250,000 |
| Maternity (Normal Delivery) | Not Covered | 30,000 | 40,000 | 50,000 |
| COVID-19 (Critical Cases) | 100,000 | 250,000 | 500,000 | 1,000,000 |
| Emergency Evacuation | Road Only | Road Only | Road Only | Road & Air |
Important Inpatient Considerations
- Waiting Periods: Vary by condition (28 days for illness, 60 days for surgery, 1 year for chronic conditions)
- Accident Coverage: No waiting period for accident-related treatments
- Child Accommodation: Parent/guardian accommodation covered for children under 12
- Post-Hospitalization: Coverage for 21 days after discharge on reimbursement basis
Outpatient Coverage Options
Afyaimara County Cover offers three outpatient options that can be added to your inpatient plan. Outpatient coverage includes consultations, diagnostics, drugs, and specialized services.
| Benefit | 25,000 Plan | 40,000 Plan | 50,000 Plan |
|---|---|---|---|
| Dental Sub-limit | Not Covered | Not Covered | 10,000 |
| Optical Sub-limit | Not Covered | Not Covered | 10,000 |
| Chronic Conditions | Covered after 1 year | Covered after 1 year | Covered after 1 year |
| Antenatal/Postnatal Care | Covered after 1 year | Covered after 1 year | Covered after 1 year |
| Co-pay per Visit | 200 | 200 | 200 |
Outpatient Services Covered
- Routine Services: Consultations, diagnostics, drugs, and dressings
- Specialized Care: Dental and optical services (including frames and lenses)
- Child Wellness: Well-baby clinics and pediatric care
- Chronic Management: Treatment for pre-existing conditions after waiting period
- Maternity Support: Antenatal and postnatal care (up to 6 weeks after delivery)
Important Note:
Outpatient coverage is only available if you have inpatient coverage. The outpatient limit you can choose depends on your selected inpatient option:
- Inpatient 100,000 → Outpatient 25,000
- Inpatient 250,000 → Outpatient 40,000 or lower
- Inpatient 500,000 → Outpatient 50,000 or lower
- Inpatient 1,000,000 → Outpatient 50,000 or lower
Eligibility & General Conditions
Understanding eligibility requirements and policy conditions is essential before enrolling in Afyaimara County Cover.
Eligibility Requirements
- Age Range: Coverage available from 0 months to 65 years
- Dependents: Includes one spouse (18-65 years) and children (0-18 years)
- Newborns: Added from birth upon notification and premium payment
- Age Verification: Applicants over 60 must submit a medical report
- Children Over 18: Must be covered as principal members
Key Policy Conditions
- Waiting Periods: 28 days for illness, 60 days for surgery, 1 year for chronic conditions
- Geographical Coverage: Kenya, Uganda, Tanzania, Rwanda, South Sudan
- Overseas Treatment: Limited to 42 days on reimbursement basis
- NHIF Coordination: Bills settled net of NHIF where applicable
- Card Usage: Medical cards issued to all members
General Exclusions
Afyaimara County Cover does not provide benefits for:
- Infertility treatments and cosmetic surgery (unless accident-related)
- Weight management programs and nutritional supplements
- Participation in professional/hazardous sports
- Treatment by unregistered practitioners
- Experimental treatments and alternative medicine
- Expenses related to intoxication, riots, or military operations
- Pandemics, epidemics, and natural disasters (unless specifically covered)
Get Your Personalized Insurance Quote Today!
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