The Ultimate Healthcare Benefits Covered Under Health Insurance You Might Not Know
When you think of getting health insurance, the first healthcare benefits that come to mind probably revolve around hospital stays, doctor’s appointments, surgical procedures and the like. These are, in fact, some of the most common healthcare benefits covered by health insurance policies. However, there are several other valuable benefits that you might not know about. They might seem unassuming at first glance but can play a significant role in keeping you healthy and happy without breaking your bank account in the process. Here are some lesser-known benefits that you should inquire about when exploring health insurance plans:
In-Patient Health Services
Our in-patient healthcare benefits cover admission to any private hospital within our network of healthcare providers at cost. We pay for the hospital bill and any associated costs from these benefits.
Our health plans provide the healthcare benefits for the following treatment and services subject to pre-authorisation:
Hospital treatment and services
We cover the following medical treatment and services:
- Hospital accommodation.
- In-patient fees for physicians, specialists, surgeons, anaesthetists, physiotherapists and other relevant specialist consultations in the hospital.
- Operating theatre charges.
- Apparatus, material, and ward and theatre medicines used in the hospital.
- Accommodation for one parent sharing the hospital room of a Liberty Health Cover dependant 12 years or younger who is treated as an in-patient. The treating doctor will need to advise us in writing that the parent should remain with the child.
In-country ambulance service
We cover in-country ambulance transport from the scene of the emergency to the nearest available medical facility.
We provide healthcare benefits for a higher level of treatment, nursing vigilance and monitoring than is available in a high-care unit when it is medically necessary.
In-hospital maternity cover
We cover the following:
- Confinement is the period of pregnancy when a woman is confined to a hospital bed (to reduce the risk of premature delivery).
- Childbirth (natural delivery)
- Midwives, and
- A non-elective caesarean section.
We provide cover for neonatal care required for a newborn baby.
We cover the cost of artificial limbs, and internal (surgically implanted) prostheses, such as:
- Orthopaedic prostheses, including hip replacements, bone lengthening devices, spinal plates and screws.
- End-vascular devices for the central nervous system, cardiac system and ophthalmic system.
We provide healthcare benefits for specialised radiology required in or out of hospitals, such as CT and MRI scans.
External medical appliances
We provide healthcare benefits for wheelchairs, glucometers, hearing aids, low-vision appliances and large orthopaedic orthotics (for example, a back brace).
We cover the cost of in-patient psychiatric treatment received at a hospital’s psychiatric unit. All treatment must be administered under the supervision of a registered psychiatrist.
Major Disease Benefit
We provide benefits for the cost of treatment (in and out of hospital) for oncology (cancer), organ transplants and renal (kidney) dialysis up to the significant disease benefit limit and subject to clinical/treatment protocols.
Our outpatient health benefits cover day-to-day medical treatment that does not require hospitalisation. We provide benefits for the following treatment and services:
GP and specialist consultations
We cover General Practitioner (GP) consultations and specialist consultations.
Acute medicines benefit
We provide benefits for medicines that are medically necessary to treat acute conditions such as colds and flu that are prescribed by a registered doctor.
Acute conditions usually appear suddenly, progress rapidly and do not last long.
We cover pathology or blood tests requested by a doctor, radiology or basic x-rays, and non-surgical procedures such as stitches or applying plaster of Paris to broken bones.
We pay for the following from your out-patient benefits:
- Hearing aid acoustician
- Speech therapy/audiology
- Occupational therapy
We include health benefits for additional coverage on the cost of out-of-hospital maternity care including:
- Blood tests
- Dentistry is covered in all plans.
- Basic dental procedures (removal of teeth and roots, fillings, preventative treatment, scaling and polishing, and x-rays)
- Specialised dentistry (root canal treatment, dentures, inlays, crowns, bridges, periodontal treatment, orthodontic treatment and surgery)
We include one eye examination per insured person per year, and frames and lenses (including contact lenses) every two years.
We include health benefits for chronic medicines to treat chronic conditions on the Liberty Health Cover Chronic Diseases List. Chronic conditions are conditions such as diabetes and high blood pressure that require medication and treatment for more than three (3) continuous months.
The Chronic Medicine Benefit covers the cost of your chronic medication.
Additional benefits for related pathology, consultations and basic radiology.
By registering with the Chronic Disease Programme, you will avoid claims for your chronic condition being paid from your day-to-day benefits.
There are several lesser-known healthcare benefits that you’ll find when browsing through different health insurance plans. These can help you to better manage the costs associated with healthcare. If you’re shopping around for a new health insurance plan, it’s a good idea to make sure it offers at least these three benefits. And if you have a health issue that requires treatment, make sure to ask if your current plan covers it.
Contact us at Shimin Insurance Agency, we are the leading insurance agency in Kenya, providing car, home, business, health insurance, Life and any other general insurance. Through establishing partnerships with various reputable insurance companies in the industry, the Agency has developed a full banquet of innovative insurance products and services that address the insurable needs of our customers and offers these services from across our branches in Kenya.