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.

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