Category:

JOB GROUPS A-M, DISCIPLINED SERVICES - PG 1-9 AND STATE COUNSEL - SL1-3 Period of Cover: TBA Table of benefits
Civil Servants/TSC Disciplined State Secretariat Services Council Job Groups Grades Grades A-G H J K L M PG 1,2,3 PG 4 PG 5 PG 6 PG 7 PG 9 - - - SL 1 SL 2 SL 3

In-patient 500,000 550,000 600,000 700,000 900,000 1,000,000

Out- patient 50,000 50,000 55,000 60,000 70,000 70,000

Life Cover 150,000 150,000 150,000 200,000 250,000 250,000

Critical Illness 37,500 37,500 37,500 50,000 62,500 62,500

Last expense 30,000 30,000 30,000 40,000 40,000 50,000

Population 129,902 20,388 19,333 27,086 10,957 4,761

Totals

212,427

Inpatient Cover: Provides for medically necessary:- Hospital bed charges (ward bed) Doctors bills Anesthetists bills Operating theatre fees Pharmacy Laboratory and investigations Outpatient Cover: Outpatient cover provides for Doctors Consultation, All laboratory tests, Radiological Tests (x-ray, MRI and CT scan), Prescriptions & Dressings, All Out Patient procedures and pharmacy Dental Cover The Dental cover provides for cost of fillings, x-rays, extractions including surgical extraction together with anesthetic fees up to a maximum of Kshs 10,000 Optical Cover The Optical cover provides for the cost of eyeglasses and eye testing (eyeglasses are limited to one pair every two years, unless otherwise proven to be medically necessary). Frames will be covered up-to Kshs 10,000.

 Special Clauses No waiting period for new employees (subject to written notification) Emergency Inpatient dental and optical will be covered within the inpatient limit. Inpatient dental and optical hospitalization resulting from an illness (apart from Laser eye Surgery) will each be covered within the inpatient limit. Claims related to expenses arising whilst the Member is temporarily abroad and requiring emergency treatment for an illness or injury that occurs during the period of travel provided that such period does not exceed six weeks in any one visit will be covered on reimbursement. Travel and accommodation costs are not covered. Treatment costs arising from a condition that requires referral treatment overseas because the treatment is not available in Kenya will be covered on reimbursement and SHALL require pre-authorization. No reimbursement claims Member Eligibility Employees actively in service between the ages of 18 years and 70 years shall be eligible for cover. Dependent children are eligible for cover from 0 month (a term baby of 38 weeks) of age up till the age of 18 years or to the age of 23 years if enrolled full-time in a recognized post-secondary institution.