APA Life 527600
APA Insurance 511600
At APA, we believe that a healthy
family is a happy family. Good health
equates to good living, that means having
everyone in the family covered for all
Our Afya Nafuu health cover, caters to everyone in your family, from a term baby born at 38 weeks to an adult 80 years of age.
Covid-19 cover limit extended to match the limits offered limits offered under chronic / pre-existing conditions limit
Including all accommodation expenses net of NHIF during your stay in the hospital. Whether in the Wards, HDU or ICU.
All prescribed drugs and dressings through our designated partners.
Any doctor related charges including those of physicians, surgeons, anesthetists, and specialists for visits and consultations.
All prescribed laboratory tests, X-rays, Ultrasounds, MRI and CT Scans.
Inpatient cover is the core cover.
Inpatient cover is the core cover.
|Overall maximum benefit per year||2,000,000||1,000,000||750,000||500,000||300,000||100,000|
|Bed limits net of NHIF||General Ward Bed||General Ward Bed||General Ward Bed||General Ward Bed||General Ward Bed||General Ward Bed|
|Prescription drugs and dressings-discharge drugs allowed up to a maximum of 30 days supply||Covered||Covered||Covered||Covered||Covered||Covered|
|Physicians, Specialist & Surgical fees, including anaesthetist fees subject to APA panel rates||Covered||Covered||Covered||Covered||Covered||Covered|
|Theatre charges, HDU & ICU||Covered||Covered||Covered||Covered||Covered||Covered|
|Physiotherapy as part of treatment||Covered||Covered||Covered||Covered||Covered||Covered|
|Pre-existing / chronic conditions/ HIV/AIDS / Congenital conditions after 12 months of cover and on full disclosure at the time of joining||300,000||250,000||200,000||150,000||100,000||50,000|
|In Patient Dental||75,000||40,000||30,000||30,000||20,000||10,000|
|Reconstructive surgery following an accident||Covered||Covered||Covered||Covered||Covered||Covered|
|Emergency dental/optical treatment following an accident||Covered||Covered||Covered||Covered||Covered||Covered|
|Post hospitalisation Treatment reimbursement only limited to the first 2 weeks after discharge||25,000||20,000||15,000||10,000||10,000||7,500|
|Accommodation costs for 1 parent staying in hospital with an insured child under 8 years.||Covered||Covered||Covered||Covered||Covered||Covered|
|Day Care Surgery under general anaesthesia||Covered||Covered||Covered||Covered||Covered||Covered|
|Home Nursing (on doctor’s recommendation)||Up to a maximum of 30 days||Up to a maximum of 30 days||Up to a maximum of 30 days||Up to a maximum of 30 days||Up to a maximum of 30 days||Up to a maximum of 30 days|
|Local ambulance to hospital for emergency cases||Covered||Covered||Covered||Covered||Covered||Covered|
|CT, MRI and PET scans subject to pre authorisation||Covered||Covered||Covered||Covered||Covered||Covered|
|1st ever emergency C-section &/or maternity related complications after being on cover for 12 months.||75,000||50,000||40,000||30,000||30,000||30,000|
|In Patient non-accidental Ophthalmology : includes cost of cataract removal (1 year waiting period)||75,000||50,000||40,000||30,000||30,000||30,000|
|Annual Limits Per Person||30,000||40,000||50,000||75,000||100,000|
|Maximum Consultation Limit per visit||1,000||1,000||1,500||1,500||1,500|
|Physicians consultation fees||Covered||Covered||Covered||Covered||Covered|
|Prescription drugs up to a maximum of 30 days||Covered||Covered||Covered||Covered||Covered|
|Specialists fees (strictly on referral by a GP)||2,000||2,000||2,000||2,000||2,000|
|X-Ray, MRI’s, CT and other diagnostic tests||Covered||Covered||Covered||Covered||Covered|
|Physiotherapy prescribed by a GP||Covered||Covered||Covered||Covered||Covered|
|Pre-existing/ Chronic conditions/ HIV AIDS/ Congenital Conditions after 12 months of cover & full disclosure at the time of joining||Covered||Covered||Covered||Covered||Covered|
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While we all adjust to the new normal; an uncertain and challenging time brought about by Covid-19, we wish to remind you that we are still here and ready to help in whatever way we can.
As the first Insurer to cover Covid-19 from the beginning of the pandemic, and even as we face the threat of the new variant entering the Country, we wish to assure you that all our medical products continue to provide coverage for covid19. We have so far paid over KES 120mn for covid19 cases.
Your respective policies specify the limits covered, and overall, all policies renewing or starting in 2021 have the limits indicated in your policy while those that were running from 2020 did not have the indication and as such, for those policies, we are committed to settling covid19 to the policy overall limits. The usual process on preauthorization for tests and admissions apply. Our family Covers such as Jamii Plus, Afya Nafuu and Simba Products have the covid19 cover limit extended to match the limits offered for chronic and pre-existing conditions. You are therefore covered for covid19 under all our health products.
In support of our partners and communities, through the Apollo Foundation, we have so far donated funds, care packages and PPES of up to KES 15mn to support those highly impacted in the society.
Our branches and offices remain open while observing Covid19 prevention protocols. Please rest assured that we are doing our very best to maintain exceptional customer service during this time. Our services are also available online including drug deliveries. We encourage you reach out to us for any concerns.