What is Ayfaimara Seniors?
- Lifetime cover - Once you join, you can renew your cover for life.
- Wide Geographical coverage and Hospital Network -Access to all of UAP Insurance Company Ltd’s comprehensive network of hospitals across East Africa. An overseas referral is available for conditions not covered locally at accredited overseas partners.
- Convenient - Air evacuation for cover limits above Kshs 1M. Road evacuation for all cover limits. Overseas emergency treatment covers 60 days for a limit on reimbursement for all cover limits.
- Affordable - No excess for inpatient cover. Instalment premium payments for your inpatient cover. No claim discount (NCD).
Please contact UAP Insurance or your insurance intermediary and fill the application form. Ensure you complete the application form in full and as accurately as possible to facilitate quick processing of your cover. Submit the duly filled form and the premium payment to UAP Insurance. All members as proposed will be issued with a membership card and a policy document will be issued for every proposal.
Persons will be required to submit a medical report in the prescribed manner for eligibility.
- Inpatient limits from Kes 500,000 to Kes 10,000,000.
- Optional outpatient cover from Kes 50,000 to Kes 200,000. This caters for:
- Routine outpatient services, consultations, diagnostics, drugs and dressings.
- Medical check-ups within the outpatient cover
- Covers pre-existing, chronic conditions & HIV/AIDs
- Dental & Optical benefits are included as an optional stand-alone cover
- Hospitalization expenses including surgeon, physician, theatre, ICU & HDU fees
- Home Nursing is subject to pre-authorisation up to 90 days from discharge based on the applicable benefit sub-limit
- Diagnostics and physiotherapists fees, prescribed drugs, dressings, surgical appliances
- Covid-19 inpatient coverage
- Persons from age of sixty-five (65) years (age next birthday) to eighty (80) years are eligible. Existing members can continue renewing in the scheme for life subject to renewal review by UAP-Old Mutual Group.
- Eligible dependent includes one legal spouse only.
- All members will be required to submit a medical report in the prescribed manner for eligibility. The tests will be at a designated provider from the UAP-Old Mutual panel.
- Cover is subject to written acceptance by UAP-Old Mutual Group after reviewing the medical report.
- If dependents are below 65 years, they will be covered under Afyaimara, Afyaimara County or Afyaimara Junior.
- Expenses where material information is withheld or misstated
- Infertility treatment
- Cosmetic surgery unless caused by accident
- Weight management treatments and drugs
- Participation in professional and hazardous sports e.g. bungee jumping, paragliding
- Treatment other than by registered medical practitioner
- Self-referred or self-prescribed treatment
- Drugs dispensed by the treating doctor
- Nutritional supplements unless prescribed as part of medical treatment
- Alternative treatment - Chiropractors, Acupuncturist, Herbalist
- Drunkenness, drug addiction, intentional self-injury
- Expenses incurred in connection with participation in riot, strike and civil commotion
- Naval, military or air force operations
- Expenses recoverable under any other insurance e.g. NHIF, GPA, WIBA
- Beauty treatment in nature cure clinics or health hydro’s
- Diagnostic equipment (e.g. Glucometers, BP machines)
- Experimental treatment
- Declared pandemics, epidemics, and natural disasters
- Contamination by radioactivity from nuclear fuel, waste, or fission
- Outpatient dental and optical claims
- Illness claims incurred within the first 28 days of cover
- Surgical claims incurred within the first 60 days of cover
- Benefits not purchased or not indicated in the brochure
The cover includes comprehensive benefits such as:
If you want to learn more about the conditions on this cover, read our brochure.
General exclusions are as follows:
*Refer to the policy document for detailed exclusions