Medical cover guide
APA medical insurance in Kenya
Compare every APA plan we quote — inpatient limits, bed entitlement, optional benefits, waiting periods and co-payments — then get a personalised quotation in minutes.
Cover typesGroup and SME / Individual and family
Products2
Inpatient limitsKSh 250,000 to KSh 10,000,000
Bed entitlementGeneral Ward Bed · Standard Private Room up to KSh 12,500/day net of SHIF · Standard Private Room up to KSh 15,000/day net of SHIF
Medical examinationApplicants aged 60 and above
APA products we quote
Individual and family
APA Jamii Plus
APA Jamii Plus covers individuals and families on a per-family inpatient limit with optional outpatient, maternity, dental and optical benefits.
Read the guide →
Group and SME
APA SME Cover
APA SME Cover is a group medical scheme for businesses, with limits from KSh 500,000 per employee and optional outpatient cover.
Read the guide →
Plans, limits and bed entitlement
APA Jamii Plus
| Inpatient limit | Plan | Bed entitlement |
|---|---|---|
| KSh 500,000 | Jamii Plus 500K | General Ward Bed |
| KSh 1,000,000 | Jamii Plus 1M | General Ward Bed |
| KSh 2,000,000 | Jamii Plus 2M | Standard Private Room up to KSh 12,500/day net of SHIF |
| KSh 3,000,000 | Jamii Plus 3M | Standard Private Room up to KSh 15,000/day net of SHIF |
| KSh 5,000,000 | Jamii Plus 5M | Ensuite Room up to KSh 18,000/day net of SHIF |
| KSh 7,500,000 | Jamii Plus 7.5M | Ensuite Room up to KSh 20,000/day net of SHIF |
| KSh 10,000,000 | Jamii Plus 10M | Private Ensuite Room up to KSh 25,000/day net of SHIF |
APA SME Cover
| Inpatient limit | Plan | Bed entitlement |
|---|---|---|
| KSh 250,000 | APA SME · KSh 250K | General Ward · Max KSh 8,000/day net of SHIF |
| KSh 300,000 | APA SME · KSh 300K | General Ward · Max KSh 8,000/day net of SHIF |
| KSh 400,000 | APA SME · KSh 400K | General Ward · Max KSh 8,000/day net of SHIF |
| KSh 500,000 | APA SME · KSh 500K | General Ward · Max KSh 8,000/day net of SHIF |
| KSh 750,000 | APA SME · KSh 750K | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 1,000,000 | APA SME · KSh 1M | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 2,000,000 | APA SME · KSh 2M | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 3,000,000 | APA SME · KSh 3M | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 4,000,000 | APA SME · KSh 4M | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 5,000,000 | APA SME · KSh 5M | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 7,500,000 | APA SME · KSh 7.5M | Standard Private Room · Max KSh 17,000/day net of SHIF |
| KSh 10,000,000 | APA SME · KSh 10M | Standard Private Room · Max KSh 22,500/day net of SHIF |
What APA cover includes
- Inpatient treatment for illness and accidents, including prescribed medicines, specialists, surgery, theatre, HDU/ICU and diagnostics
- Pre-existing, chronic, congenital and HIV/AIDS conditions after 12 months and full disclosure
- Newly diagnosed chronic conditions after 3 months
- Prematurity and neonatal conditions subject to the published waiting period and sub-limits
- Organ transplantation subject to a 2-year waiting period
- Psychiatry and psychotherapy within published sub-limits
- Post-hospitalisation treatment, home nursing, local ambulance and emergency air evacuation
- First emergency C-section / maternity complications within inpatient sub-limit after 10 months
- Inpatient accidental and non-accidental dental/ophthalmology benefits
- APA Femina Plus cancer diagnosis cash benefit
- Optional outpatient, maternity, dental and optical benefits
Waiting periods
- 30 days acute illness
- 90 days non-chronic surgical procedures
- 3 months newly diagnosed chronic conditions
- 10 months pregnancy/maternity
- 12 months pre-existing/chronic/congenital conditions and specified surgeries
- 2 years organ transplant
- No waiting period for accidental cases
Co-payment, where it applies
- KSh 1,500 at Aga Khan University Hospital, Nairobi Hospital, Premier Hospital, Nyali Children’s Hospital, Diani Beach Hospital, Maimooni Hospital, Mombasa Hospital, Mater Hospital and MP Shah Hospital
- KSh 500 at Gertrude’s Children’s Hospital, Avenue Hospital, Pandya Hospital, Eldoret Hospital, Nairobi West Hospital, Metropolitan Hospital, Oasis Doctors Plaza, Jocham Hospital, Palm Beach Hospital, Oasis Health Care Group and AAR Healthcare/Hospital
- All other providers: No Copayment
How cover and payment work
Cover is arranged through APA and the premium is paid directly to the insurer — by the payment ' 'methods printed on your quotation — never to Now Insurance Agency. We prepare the application, ' 'check it against the insurer's requirements and follow it through to activation. Cover is ' 'typically confirmed within 1 to 5 working days of payment and complete documents, subject to ' 'insurer underwriting and acceptance.
Read more about paying the insurer or check the ' 'provider network before you choose a limit.
APA medical cover — frequently asked questions
How do I get a APA medical cover quotation?
Use our online quote form. Choose who is covered, the inpatient limit and any optional benefits, and every suitable APA plan is priced side by side with a downloadable quotation.
What inpatient limits does APA offer?
The limits available on our quotation are listed in the plans table above. Each limit is a separate plan with its own benefits schedule, and the premium changes with the limit, the members covered and their ages.
Are outpatient, maternity, dental and optical benefits included?
They are chosen separately on top of the inpatient cover. Where a plan offers them, the selectable amounts are listed above; the premium is shown before you apply.
How is the premium paid?
Premiums are paid directly to APA using the payment details printed on your quotation. Now Insurance Agency never collects client payments. Once you pay, send us the confirmation and we follow up on cover processing.
Does anyone need a medical examination?
Medical examination requirements for APA: applicants aged 60 and above. Where a form is needed we send it with your application pack.
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