Medical cover guide
AAR SME Cover — limits, benefits and options
AAR SME Cover gives small and medium businesses a staff medical scheme priced per employee, with choice of inpatient limit and optional outpatient cover.
Cover typeGroup and SME
Inpatient limitsKSh 250,000 to KSh 10,000,000
Plans available22
Medical examinationApplicants aged 56 and above
AAR SME Cover — inpatient limits
| Inpatient limit | Bed entitlement | Plan |
|---|---|---|
| KSh 250,000 | KSh 8,000/day | SME Medical · 250,000 |
| KSh 500,000 | KSh 8,000/day | SME Medical · 500,000 |
| KSh 750,000 | KSh 8,000/day | SME Medical · 750,000 |
| KSh 1,000,000 | KSh 10,000/day | SME Medical · 1,000,000 |
| KSh 1,500,000 | KSh 11,000/day | SME Medical · 1,500,000 |
| KSh 2,000,000 | KSh 12,000/day | SME Medical · 2,000,000 |
| KSh 2,500,000 | KSh 13,000/day | SME Medical · 2,500,000 |
| KSh 3,000,000 | KSh 14,000/day | SME Medical · 3,000,000 |
| KSh 3,500,000 | KSh 14,000/day | SME Medical · 3,500,000 |
| KSh 4,000,000 | KSh 15,000/day | SME Medical · 4,000,000 |
| KSh 4,500,000 | KSh 16,000/day | SME Medical · 4,500,000 |
| KSh 5,000,000 | KSh 17,500/day | SME Medical · 5,000,000 |
| KSh 5,500,000 | KSh 18,000/day | SME Medical · 5,500,000 |
| KSh 6,000,000 | KSh 20,000/day | SME Medical · 6,000,000 |
| KSh 6,500,000 | KSh 20,000/day | SME Medical · 6,500,000 |
| KSh 7,000,000 | KSh 20,000/day | SME Medical · 7,000,000 |
| KSh 7,500,000 | KSh 20,000/day | SME Medical · 7,500,000 |
| KSh 8,000,000 | KSh 22,500/day | SME Medical · 8,000,000 |
| KSh 8,500,000 | KSh 22,500/day | SME Medical · 8,500,000 |
| KSh 9,000,000 | KSh 22,500/day | SME Medical · 9,000,000 |
| KSh 9,500,000 | KSh 22,500/day | SME Medical · 9,500,000 |
| KSh 10,000,000 | KSh 25,000/day | SME Medical · 10,000,000 |
Premiums depend on the members covered and their ages, so the price for a limit is confirmed in your quotation.
Optional benefits you can add
Depending on the plan you choose, the following can be added to the inpatient cover:
- Outpatient: KSh 50,000, KSh 75,000, KSh 100,000, KSh 150,000, KSh 200,000, KSh 250,000
What the cover includes
- Inpatient cover for accident and illness up to the plan limits
- Re-constructive surgery
- Maternity services including normal, elective or emergency CS delivery
- Parent/guardian accommodation for insured child under 8 years
- Organ transplant
- Post-hospitalisation discharge medication up to 14 days
- Accidental damage to natural teeth
- Accidental damage to eyes
- Ectopic pregnancy
- Laboratory services
- Radiotherapy and chemotherapy including X-rays, MRI and CT scans
- Cancer tests and consultation
- Dental treatment within outpatient
- Optical services within outpatient
- Pre-natal and post-natal care
- Political violence medical injuries
- Local & international rescue and evacuation
- Nutritional advice
- 24-hour call centre
- Health camps and health alerts
Benefit sub-limits (pre-existing conditions, chronic conditions, maternity, psychiatric care, last expense and so on) are printed on every quotation we issue and are listed in the insurer's brochure.
Waiting periods
- 14 days outpatient
- 30 days inpatient
- No waiting period for accidents
- 6 months newly diagnosed chronic
- 1 year maternity
Co-payment, where it applies
- KSh 500 at Nairobi Hospital, Aga Khan University Nairobi, Aga Khan Mombasa, Aga Khan Kisumu, Mater Hospital, Gertrude’s Children Hospital, Karen Hospital, M P Shah and Nyali Healthcare (including satellite clinics)
AAR SME Cover — frequently asked questions
What inpatient limits are available on AAR SME Cover?
The limits we quote are KSh 250,000 to KSh 10,000,000 per year. Each limit is a separate plan with its own benefits schedule, so the premium and the sub-limits change with the limit you pick.
Can I add outpatient, maternity, dental or optical cover?
Yes. Depending on the plan, optional benefits can be added at the amounts listed above. Outpatient cover is normally required before dental or optical benefits can be selected.
Who can be covered?
This product is a group scheme, so cover is arranged for a business with a minimum number of families or employees. The quote engine shows the family sizes and head count the insurer accepts.
How is the premium paid?
Premiums are paid directly to AAR using the payment details printed on your quotation. Now Insurance Agency does not receive or handle client payments.
How long does cover take to start?
Cover is typically confirmed within 1 to 5 working days after payment or IPF settlement and receipt of complete documents, subject to the insurer's underwriting and acceptance.
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