Did you know that Co-operative Bank has a package designed to offer medical insurance cover? Well, with the advent of insurance policies and coverage, Kenyans ar turning to established insurance institutions with the capital and managerial stability that guarantees safe, assured and stable policies. The Co-op Bank Medical insurance is one of these. Apart from providing policy for areas such as motor vehicles, agri-business, life cover and micro-business, Co-op Bank has a insurance package for consumers looking for secured medical policies.
To apply and learn more, you may visit your nearest Co-op Bank branch or simply CLICK HERE.
Today, Bizna takes a look at what the Co-op Bank medical insurance offers:
Waiting periods
- 120 days for non-accidental surgery, Gynecological and ENT surgery
- 6 months for disclosed pre-existing, chronic, congenital and HIV/AIDS & related conditions
- 12 months waiting period for cancer
- Newly diagnosed chronic ailments are not subject to the waiting period but the amount payable is limited to the sublimit for pre-existing & chronic ailments.
- 12 months for maternity and 1st Ever Emergency claims
- All illnesses (inpatient and outpatient) are subject to 30 days waiting period
In and Out patient bundles
| COVER TYPE | IN PATIENT | OUT PATIENT |
|---|---|---|
| LILAC | 200,000/= | 20,000/= |
| BLOSSOM | 400,000/= | 25,000/= |
| JASMINE | 600,000/= | 30,000/= |
| ORCHID | 800,000/= | 40,000/= |
| DAISY | 1,000,000/= | 50,000/= |
| LILY | 2,000,000/= | 70,000/= |
| TULIP | 3,000,000/= | 80,000/= |
| JACARANDA | 5,000,000/= | 120,000/= |
Exclusions
- Self referred or self prescribed treatment
- Family planning, infertility & impotence
- Intentional self- injury, chronic drunkenness, suicide or attempted suicide, drug and substance abuse, hazardous pursuits(sports and hobbies)
- Cosmetic and beauty treatment (unless necessitated by accidental injury)
- Outpatient ambulance services
- Experimental treatment or treatment subject to medical research
- Weight management treatment and drugs
- Diagnostic equipment(glucometers, BP Machines etc and hearing aids
- General medical checkups not incidental to diagnosis of an illness or Injury
- External surgical appliances(crutches and wheelchairs and prosthesis
- Dental prosthesis, crowns, dentures, bridges and braces
- Alternative medicine ( acupuncture, chiropractor, herbal medicine).
- Treatment outside the appointed panel of service providers
- Nutritional supplements unless prescribed as part of medical treatment of specified conditions
- Adult vaccinations and private vaccines for children.
- Costs of donor and related cost transplant for organ transplant
- Optical services including eg eye glasses/lenses/frames, eye testing, transplants/grafts and laser surgery
Conditions
- Waiting period is not applicable for accidental cases or persons transferring from another Medical Insurance Policy
- Outpatient treatment can only be purchased at the inception/renewal of the policy and not during the term of the policy
- Members not subjected to medicals tests on joining.
- No cash deposit required and no contribution to the bill by the customer.
- Extensive service provider/Hospital network
Outpatient procedures
- Present your membership smart card at the service provider’s (doctor, clinic or hospital) facility’s desk for identification.
- Your membership will be checked and confirmed using your smartcard and fingerprints.
- Complete and sign the claim form which will be made available at the service provider’s facility. The attending physician/specialist must also complete and sign the claim form. A claim form must be completed for each episode of treatment and for each person.
- All bills will be sent by the service provider directly.
