Protecting your family has never been this easy. Here at APA we are making it easier for you to tend to your family’s health needs so you never miss out on the important moments. Afya Nafuu will pay for hospitalization ( In-Patient and out-patient) expenses arising out of an illness or accident for you and your family.
The expenses covered include but are not limited to :
- Bed charges: all your accommodation charges during your stay in hospital whether in the ward, HDU or ICU
- Doctors’ fees: all your doctors’ charges be they physicians, surgeons and specialists for visits and treatment.
- Drugs: all medicines required for your speedy recovery
- Diagnostics: all procedures required to find out what you are suffering from. Laboratory tests, X-rays, Ultrasound scans
- All Premiums must be paid in full before commencement of cover
- In Patient bills are paid net of National Hospital Insurance Fund (NHIF)
- We will settle the doctors’ fee in full if you are using the APA panel of doctors. In other cases the bills are settled 85% of the costs or the APA panel rates whichever is lower.
- All scheduled admissions must be reported to APA insurance with at least 48 hours’ notice.
- For emergency admissions, the hospitals will contact APA within 48 hours of the patient being admitted
- All waiting periods are subject to continuous renewal with no break in cover. Where there is a break in cover the waiting periods will apply afresh.
- Members must produce their medical cards to enable them access treatment at the accredited panel of providers.
- Premiums are calculated based on the members age at the next birthday
- Benefits may not be payable if there is non-disclosure of any material facts on application. APA reserves the right to decline an application or renewal.
- Cover outside Kenya up to 6 weeks for business or leisure travel on reimbursement basis
- Geographical limit – Kenya
- Time bar at sixty (60) days from the day of ailment for reimbursement claims.