Mwalimu Golden Product Health Cover- Full Details
Welcome to the….
Golden Product Health Cover.
As a society, our members are our greatest asset and therefore our main concern is to ensure they continue enjoying healthy and dignified lives even after retirement. Mwalimu National through its subsidiary MNS Risk and Insurance Brokers, have packaged a unique solution to ensure our senior members age of 50-80 years and their families get the much-needed health care pre and after retirement.
Why Golden Product?
- The cover is
- Premium financing is
- The cover has various plans for your
- Pre-existing and Chronic conditions are
- 14 days waiting
- No medical checks required at
- No co-payments in all health
- Wide geographical
- Funeral cover and Personal accident cover at no additional
- Access to Maisha Fiti Wellness Program
- Members and their dependants are eligible
Joining:
Anyone up to the age of 50-80 years can sign up. Members who are in the medical scheme shall enjoy lifetime cover.
Requirements:
Copy of ID and KRA PIN, duly executed application form and premium payment.
| Benefit Schedule | A | B | C | D | E | F | G |
| Inpatient (Compulsory) | 10,000,000 | 5,000,000 | 4,000,000 | 3,000,000 | 2,000,000 | 1,000,000 | 750,000 |
| Outpatient | 200,000 | 150,000 | 100,000 | 100,000 | 100,000 | 100,000 | 75,000 |
| Dental | 30,000 | 30,000 | 30,000 | 30,000 | 30,000 | 30,000 | 30,000 |
| Optical | 30,000 | 30,000 | 30,000 | 30,000 | 30,000 | 30,000 | 30,000 |
| Bed Limit net of NHIF | 22,500 SPR | 16,500 SPR | 15,000 SPR | 12,500 SPR | 12,500 SPR | General Ward | General Ward |
| Accident Waiting period | 0 Days | 0 days | 0 days | 0 days | 0 days | 0 days | 0 days |
| Entry Age | 50-80 years | 50-80 years | 50-80 years | 50-80 years | 50-80 years | 50-80 years | 50-80 years |
| Pre-existing & Chronic condition | 1,250,000 | 750,000 | 600,000 | 500,000 | 400,000 | 350,000 | 300,000 |
| Hearing Aids | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 |
| Confirmed newly diagnosed chronic condition after 3 months | 4,000,000 | 2,500,000 | 2,000,000 | 1,500,000 | 1,000,000 | 500,000 | 375,000 |
| Post- Hospitalization Treatment- Up to 3 weeks after discharge from Hospital | 300,000 | 15,000 | 15,000 | 15,000 | 15,000 | 15,000 | 15,000 |
| Last Expense for Principal member | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 | 75,000 | 50,000 |
| Benefit Schedule | A | B | C | D | E | F | G |
| Congenital conditions | 300,000 | 200,000 | 200,000 | 200,000 | 200,000 | 200,000 | 150,000 |
| Inpatient non- accident Dental | 300,000 | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 |
| Inpatient non-accident ophthalmology | 300,000 | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 | 100,000 |
| Lodger Benefit | Up to 10 years | Up to 10 years | Up to 10 years | Up to 10 years | Up to 10 years | Up to 10 years | Up to 10 years |
| KEPI & Baby friendly Regime immunization | Covered up to 5,000 | Covered up to 5,000 | Covered up to 5,000 | Covered up to 5,000 | Covered up to 5,000 | Covered up to 5,000 | Covered up to 5,000 |
| Air Evacuation | Covered within inpatient limit | Covered within inpatient limit | Covered within inpatient limit | Covered within inpatient limit | Covered within inpatient limit | Covered within inpatient limit | Covered within inpatient limit |
The correct prorated premium will be issued by our underwriting team after a member fills in the application form.
| Inpatient | Premium Per Family | |||||
| Category | Limit | M | M+1 | M+2 | M+3 | M+4 |
| A | 10,000,000 | 96,974 | 133,825 | 161,948 | 190,072 | 218,192 |
| B | 5,000,000 | 74,746 | 103,149 | 124,826 | 146,502 | 168,180 |
| C | 4,000,000 | 71,785 | 99,065 | 119,883 | 140,701 | 161,518 |
| D | 3,000,000 | 67,970 | 93,799 | 113,511 | 133,222 | 152,934 |
| E | 2,000,000 | 60,675 | 83,732 | 101,329 | 118,925 | 136,520 |
| F | 1,000,000 | 47,084 | 64,975 | 78,630 | 92,283 | 105,937 |
| G | 750,000 | 43,724 | 60,340 | 73,020 | 85,701 | 98,382 |
| Outpatient | Premium Per Family | |||||
| Category | Limit | M | M+1 | M+2 | M+3 | M+4 |
| A | 200,000 | 60,258 | 83,158 | 100,631 | 118,107 | 135,582 |
| B | 150,000 | 56,196 | 77,550 | 93,846 | 110,143 | 126,439 |
| C | 100,000 | 45,091 | 62,225 | 75,302 | 88,379 | 101,454 |
| D | 100,000 | 45,091 | 62,225 | 75,302 | 88,379 | 101,454 |
| E | 75,000 | 41,461 | 57,216 | 69,240 | 81,263 | – |
| F&G | 75,000 | 41,461 | 57,216 | 69,240 | 81,263 | – |
| Category | Dental | M | M+1 | M+2 | M+3 | M+4 |
| A | 50,000 | 15,377 | 30,755 | 46,132 | 61,509 | 76,886 |
| B | 40,000 | 12,332 | 24,665 | 36,997 | 49,329 | 61,661 |
| C | 30,000 | 9,287 | 18,575 | 27,862 | 37,149 | 46,436 |
| D | 20,000 | 6,452 | 12,905 | 19,357 | 25,809 | 32,262 |
| E | 15,000 | 4,839 | 9,677 | 14,516 | 19,354 | 24,193 |
| F&G | 10,000 | 3,226 | 6,451 | 12,903 | 25,805 | 51,611 |
| Category | Optical | M | M+1 | M+2 | M+3 | M+4 |
| A | 50,000 | 15,925 | 31,851 | 47,776 | 63,701 | 79,627 |
| B | 40,000 | 12,688 | 25,375 | 38,063 | 50,750 | 63,438 |
| C | 30,000 | 9,490 | 18,981 | 28,471 | 37,961 | 47,451 |
| D | 20,000 | 7,485 | 14,969 | 22,454 | 29,938 | 37,423 |
| E | 15,000 | 5,613 | 11,226 | 16,839 | 22,452 | 28,065 |
| F&G | 10,000 | 3,742 | 7,485 | 14,969 | 29,938 | 59,877 |
| Premium exclusive of 0.45% (Training Levy & Policyholders funds) and Stamp Duty (Kshs 40.00) | ||||||
Some of the exclusions include:
- Family planning and fertility treatment e., costs of treatment related to infertility and impotence.
- Intentional self-injury, suicide or attempted suicide, intoxication, drunkenness
- Expenses recoverable under any other insurance
- Cosmetic surgery, massage, or beauty treatment
- Naval, Military and Air force operations
- Riding or driving in any kind of
- Participation in extreme sports
- Stays at sanatoria, old age homes, places of rest
- Injury sustained while in a state of
- War, invasion, civil war, riots, or act of terrorism
- Chiropractors, acupuncturists, or herbalist’s treatment
- STD’s
Purchase insurance products online at your comfort, visit www.bimamfukoni.com and get started.
