Can I keep my own doctor?

If your doctor is on the insurer's panel, yes. We can match insurer panels to the specialists you currently see before you commit. For consultants who are not on a panel, you can usually claim reimbursement up to the plan's normal-and-reasonable charges.

How does individual cover interact with SHIF?

SHIF is mandatory; your private medical insurance sits on top. Most insurers now require you to attempt to use SHIF first for eligible benefits, with private cover paying the balance. The practical effect is that good private cover is more important than ever.

What is the waiting period for new policies?

Standard waiting periods are: 30 days for general illness, 12 months for maternity, 24 months for some pre-existing and chronic conditions. Accidents are typically covered from day one.

Can I switch insurers without losing my waiting period credit?

Yes — most major Kenyan insurers honour portability for continuous private cover. We collect a continuation letter from your existing insurer so you don't restart waiting periods.

Health & Medical Insurance

Individual Medical Insurance

Inpatient and outpatient cover for individuals — hospital stays, surgery, specialist consultations, and chronic condition management.

Get an Individual Medical Quote Talk to an Advisor

Inpatient + outpatientMaternity & dental optionsCashless hospital networkPlans from KES 25k/year

Cashless

Hospital Access

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Renewal Discounts

Cashless

Hospital Access

Loyalty

Renewal Discounts

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Since the transition from NHIF to the Social Health Authority (SHA) in October 2024, private medical cover has become more important than ever for Kenyans who want predictable access to quality healthcare. Individual medical insurance fills the gap between SHIF's public-scheme limits and the actual cost of care at Aga Khan, Nairobi Hospital, MP Shah, Karen Hospital, Avenue, and the country's other leading private facilities.

Vike compares individual medical plans from Jubilee Allianz, AAR, CIC, Britam, APA, Madison, Old Mutual, Heritage, and ICEA Lion. The right plan depends on your age, where you want to be treated, whether you need maternity or chronic condition cover, and how much excess you are comfortable carrying. We walk you through the trade-offs in plain English before you commit to a 12-month contract.

What It Covers

Inpatient — hospital admission, surgery, ICU, theatre fees, drugs, and consumables
Outpatient — GP and specialist consultations, diagnostics, and prescribed drugs
Pre- and post-hospitalisation expenses (typically 30–90 days each side)
Day-care procedures — minor surgeries not requiring overnight admission
Emergency local and overseas evacuation on most schemes
Chronic condition management (diabetes, hypertension, asthma) subject to disclosure
Optical and dental as optional riders or built into higher tiers
Cashless admission at the insurer's panel hospitals

Who It's For

Self-employed Kenyans and freelancers without employer medical cover
Retirees and pre-retirees wanting predictable private healthcare access
Spouses of employed members topping up corporate cover with personal extras
Kenyans returning from overseas who want continuity of private care

Types We Cover

Each profile is rated and underwritten differently. Talk to us so we can match your specific situation.

Standard Inpatient Plans

The cheapest entry point. Covers hospital admission, surgery, and ICU up to an annual limit (typically KES 500K to KES 5M per family member). Outpatient is excluded or available as a cheap add-on.

Comprehensive Inpatient + Outpatient

The most common adult cover. Combines inpatient limits with an outpatient pot (e.g. KES 100K–250K) for consultations, diagnostics, and pharmacy. Suitable for most healthy adults.

High-Limit Plans

Inpatient limits of KES 10M+ per member with broader hospital panels including overseas treatment. For senior executives, high-net-worth individuals, and those with significant chronic risk.

Senior Citizen Plans

Tailored for members aged 60+, where most standard plans either decline or load heavily. Different rating, age-band limits, and typically excludes maternity.

Real-World Scenarios

Appendicitis surgery at MP Shah

A KES 380,000 bill for emergency appendectomy and three nights' admission. A comprehensive individual plan with a KES 1M inpatient limit settles directly with the hospital — no upfront payment from you beyond any small excess.

Chronic hypertension management

Monthly consultations and prescription refills add up to KES 8,000–12,000. A plan with an outpatient limit of KES 150,000 and chronic condition cover (disclosed and accepted on the application) handles this with no hassle. Many cheaper plans exclude chronic conditions — we always confirm wording before placing.

Air evacuation from Diani after a road accident

AMREF evacuation to Nairobi for trauma care typically costs KES 600,000+. Most individual plans include emergency evacuation by default. We confirm the airlift partner and limit on every plan we recommend.

Optional Benefits & Add-ons

Outpatient rider (for inpatient-only plans)

Maternity cover (12-month waiting period applies)

Optical — frames, lenses, contact lenses

Dental — routine and major dental work

Chronic condition top-up for diabetes, hypertension, etc.

International / overseas treatment cover

Availability varies by underwriter. Our advisors will confirm what is available on your chosen policy.

Frequently Asked Questions

It depends on disclosure and the insurer. Most plans either (a) cover declared pre-existing conditions after a 12-month waiting period, (b) cover them at an additional premium, or (c) exclude them outright. Honest disclosure on the application form is critical — undisclosed conditions void claims.